Individual provider Active NPI

Kelly Anne Bruch, RN, MSN, CNM

  • Advanced Practice Midwife
  • Grand Rapids, MI
National Provider Identifier
1235876178
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
4704330667 Issued in MI
Practice address
80 68TH St SE Ste 301
Grand Rapids, MI 49548-6980
Phone
(616) 391-3302
NPI assigned
May 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 4704330667 MI Primary

Addresses

Primary practice location

80 68TH St SE Ste 301
Grand Rapids, MI 49548-6980

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kbruch109656@direct.hurleymc.com
Direct Messaging Address kbruch6558074@direct.beaumont.edu

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220825003558 MI Practitioner - Certified Nurse Midwife (CNM) 9335523224 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Master of Science - Nursing, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Jul 1, 2024 Accepting new patients
Hurley Medical Center Current Accepting new patients
Hurley Medical Center Current Accepting new patients
Pathology Associates Inc PC Current Accepting new patients
Hurley Medical Center CurrentSince Sep 1, 2022 Accepting new patients
Hurley Medical Center CurrentSince Sep 1, 2022 Accepting new patients
Beaumont Medical Group Hospital -Based Services CurrentSince Oct 16, 2023 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 1, 2024 Accepting new patients
Hurley Medical Center Past Accepting new patients

Locations

7128 Fulton St E
Ada, MI 49301
Phone (616) 825-3500

4272 W Vienna Rd
Clio, MI 48420
Phone (810) 687-2850

102 N Adelaide St
Fenton, MI 48430
Phone (810) 629-2245

1 Hurley Plz
#2N
Flint, MI 48503

1 Hurley Plz
Ste 2N
Flint, MI 48503

6140 Rashelle Dr
Flint, MI 48507
Phone (810) 262-2330

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

80 68th St SE
Ste 301
Grand Rapids, MI 49548
Phone (616) 391-3302

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

1794 N Lapeer Rd
Lapeer, MI 48446
Phone (810) 245-1800

3601 W 13 Mile Rd
Royal Oak, MI 48073

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

Interoperability endpoints

  • Direct secure messaging: kbruch1663825@epic00.shdirect.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1235876178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 68TH ST SE STE 301",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486980",
            "telephone_number": "616-391-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCH",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "credential": "RN, MSN, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704330667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbruch109656@direct.hurleymc.com",
            "affiliation": "N",
            "address_1": "1 Hurley Plz # 2N",
            "city": "Flint",
            "state": "MI",
            "country_code": "US",
            "postal_code": "485035902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbruch6558074@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3601 W 13 Mile Rd",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.