Individual provider Active NPI

Kristen Joy Kelting

  • Acute Care Nurse Practitioner
  • Wyoming, MI
National Provider Identifier
1114494895
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704299090 Issued in MI
Practice address
5900 Byron Center Ave SW
Wyoming, MI 49519
Phone
(616) 252-7200
NPI assigned
Oct 31, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704299090 MI Primary

Addresses

Primary practice location

5900 Byron Center Ave SW
Wyoming, MI 49519

Mailing address

5900 Byron Center Ave SW
Wyoming, MI 49519-9686
Phone (616) 252-7200

Other practice location 1

4364 Cuper Ave
Dorr, MI 49323-9062
Phone (616) 862-0782

Other practice location 2

4364 Cuper Ave
Dorr, MI 49323-9062
Phone (616) 862-0782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181215000296 MI Practitioner - Nurse Practitioner 3971848144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

5900 Byron Ctr Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-3243

Hospital & facility affiliations

  • University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704299090MIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital CurrentSince Dec 1, 2018 Accepting new patients
Metropolitan Hospital Past Accepting new patients

Locations

5900 Byron Center Ave SW
#U
Wyoming, MI 49519
Phone (616) 252-3243

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

Interoperability endpoints

  • Direct secure messaging: kkelting63651@direct.metrohealth.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1114494895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199686",
            "telephone_number": "616-252-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49519",
            "telephone_number": "616-252-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4364 Cuper Ave",
            "address_purpose": "LOCATION",
            "city": "Dorr",
            "state": "MI",
            "postal_code": "493239062",
            "country_code": "US",
            "telephone_number": "616-862-0782",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4364 Cuper Ave",
            "address_purpose": "LOCATION",
            "city": "Dorr",
            "state": "MI",
            "postal_code": "493239062",
            "country_code": "US",
            "telephone_number": "616-862-0782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELTING",
        "first_name": "KRISTEN",
        "middle_name": "JOY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704299090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.