Individual provider Active NPI

Kevin F Dedoe, NP

  • Nurse Practitioner
  • Wyoming, MI
National Provider Identifier
1154662443
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704260411 Issued in MI
Practice address
5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone
(616) 252-7200
NPI assigned
Mar 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704260411 MI Primary

Addresses

Primary practice location

5900 Byron Center Ave SW
Wyoming, MI 49519-9606

Mailing address

2122 Health Dr SW
Wyoming, MI 49519-9698
Phone (616) 252-7200

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
I20130424000802 MI Practitioner - Nurse Practitioner 7315183043 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Rush Medical College of Rush University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians

Practice addresses (Care Compare)

1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone (269) 226-5165

1535 Gull Rd
Suite 130
Kalamazoo, MI 49048-1659
Phone (269) 345-1161

411 Naomi St
Plainwell, MI 49080-1222
Phone (269) 685-6811

555 Linn St
Allegan, MI 49010-1524
Phone (269) 381-3963

711 S Health Pkwy
Three Rivers, MI 49093-9387

7901 Angling Rd
Portage, MI 49024-0714

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704260411MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Promed CurrentSince Apr 1, 2013 Accepting new patients
Promed Healthcare CurrentSince Apr 1, 2013 Accepting new patients

Locations

555 Linn St
Allegan, MI 49010
Phone (269) 673-8424

3035 Capital Ave SW
Battle Creek, MI 49015
Phone (269) 565-9100

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

1535 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5927

5943 Stadium Dr
Kalamazoo, MI 49009
Phone (269) 280-4586

1535 Gull Rd
Ste 130
Kalamazoo, MI 49048
Phone (269) 345-1161

671 Allegan St
Plainwell, MI 49080
Phone (269) 685-1002

671 Allegan St
Ste B
Plainwell, MI 49080
Phone (269) 685-3123

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

711 S Health Parkway
Ste 1
Three Rivers, MI 49093
Phone (269) 273-8557

711 S Health Parkway
Three Rivers, MI 49093
Phone (269) 273-9691

Organizations & group practices 3

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 3

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": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1154662443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 HEALTH DR SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199698",
            "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": "495199606",
            "telephone_number": "616-252-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDOE",
        "first_name": "KEVIN",
        "middle_name": "F",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-12",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704260411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.