Active NPI
Kelsey Elise Adkins
- Student in an Organized Health Care Education/Training Program
- Jenison, MI
National Provider Identifier
1245794304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 5302044598
- Practice address
- 1965 Baldwin St
Jenison, MI 49428-8915 - Phone
- (616) 457-9630
- NPI assigned
- Jan 23, 2019
- Last updated
- Jan 23, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 5302044598 | MI | Primary |
Addresses
Primary practice location
1965 Baldwin St
Jenison, MI 49428-8915
Mailing address
569 Douglas Fir Dr NE
Sparta, MI 49345-8272
Phone (616) 205-6860
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302044598 | MI | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Fare, LLC | Past | Accepting new patients | |
| Family Fare, LLC | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548201600000",
"number": "1245794304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "569 DOUGLAS FIR DR NE",
"city": "SPARTA",
"state": "MI",
"postal_code": "493458272",
"telephone_number": "616-205-6860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1965 BALDWIN ST",
"city": "JENISON",
"state": "MI",
"postal_code": "494288915",
"telephone_number": "616-457-9630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADKINS",
"first_name": "KELSEY",
"middle_name": "ELISE",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-23",
"last_updated": "2019-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "5302044598",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jenison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.