Individual provider Active NPI

Kristina Powell

  • Family Medicine Physician
  • Grand Haven, MI
National Provider Identifier
1184369290
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101027549 Issued in MI
Practice address
1445 Sheldon Rd Ste 300
Grand Haven, MI 49417-2479
Phone
(616) 296-1500
Fax
(616) 296-1502
NPI assigned
May 3, 2022
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101027549 MI Primary

Addresses

Primary practice location

1445 Sheldon Rd Ste 300
Grand Haven, MI 49417-2479

Mailing address

1445 Sheldon Rd Ste 300
Grand Haven, MI 49417-2479
Phone (616) 296-1500

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250628000128 MI Practitioner - Family Practice 7315450855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Physician NetworkGroup PAC ID 8921996307, 109 clinicians

Practice addresses (Care Compare)

2006 Holton Rd
Muskegon, MI 49445-1505
Phone (231) 672-3333

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Physician Network Family Medicine CurrentSince Jul 15, 2025 Accepting new patients
Mercy Physician Network Family Medicine CurrentSince Jul 15, 2025 Accepting new patients

Locations

3443 Farr Rd
Fruitport, MI 49415
Phone (231) 672-2900

1445 Sheldon Rd
Ste 300
Grand Haven, MI 49417
Phone (616) 296-1500

2006 Holton Rd
North Muskegon, MI 49445
Phone (231) 672-3333

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13864/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kpowell1836921@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1184369290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 SHELDON RD STE 300",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172479",
            "telephone_number": "616-296-1500",
            "fax_number": "616-296-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 SHELDON RD STE 300",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172479",
            "telephone_number": "616-296-1500",
            "fax_number": "616-296-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "KRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-03",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101027549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

Verify at the official NPI Registry.