Kelly Jo Wysocki-Emery, RN

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

4704230542 Issued in MI

Practice address

233 Fulton St E # 114E
Grand Rapids, MI 49503-3200

Phone

(616) 485-6757

Fax

(616) 333-7710

NPI assigned

Oct 29, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Baby Beloved, Inc.

  • Registered Nurse
  • Grand Rapids, MI
  • NPI 1891742623
  NPD Authorized official

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

{
    "created_epoch": "1319846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1194001594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 BRIDGE ST NW APT 1400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045393",
            "telephone_number": "616-485-6757",
            "fax_number": "616-333-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 FULTON ST E # 114E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033200",
            "telephone_number": "616-485-6757",
            "fax_number": "616-333-7710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 Bridge St NW Apt 1400",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495045393",
            "country_code": "US",
            "telephone_number": "616-485-6757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYSOCKI-EMERY",
        "first_name": "KELLY",
        "middle_name": "JO",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-29",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MI",
            "license": "4704230542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James M. Wynalda, M.D.
• Heather L Wynia
• Sandra Jean Wynn-Stelt, MA LLP BCBA
• Barbara N Wynn, MD
• Amanda Wynsma
• Katelyn Wysocki, MA, LPC
• Olivia Pei Xue, CTRS
• Stuart A Yablon, M.D.
• Rylie Yager
• Annie M Yakes, LMSW

• Lactation Consultant (Registered Nurse) in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Lactation Consultant (Registered Nurse) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.