Kelley Marie Young, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704210304 Issued in MI

Practice address

12520 Crockery Creek Drive
Ravenna, MI 49451

Phone

(231) 853-2954

Fax

(231) 853-6089

NPI assigned

Apr 10, 2008

Last updated

Apr 10, 2008By the provider in NPPES

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

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

Specialty

Nurse Practitioner

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ravenna Family Practice PCGroup PAC ID 8224023148, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

• Ravenna Family Practice, P.C.

  • Family Medicine Physician
  • Ravenna, MI
  • NPI 1497928469
  Medicare reassignment Care Compare group NPD
• Accelerated Care of Michigan

  • Ophthalmic Assistant
  • Essexville, MI
  • NPI 1265640700
  NPD (past)
• Norton Shores Internal Medicine & Nephrology PLC

  • Nephrology Physician
  • Muskegon, MI
  • NPI 1134357528
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Health Partners

  dba Mercy Health Muskegon

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  Care Compare affiliation

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1346413309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12520 CROCKERY CREEK DRIVE",
            "address_2": "P.O. BOX 179",
            "city": "RAVENNA",
            "state": "MI",
            "postal_code": "494510179",
            "telephone_number": "231-853-2954",
            "fax_number": "231-853-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12520 CROCKERY CREEK DRIVE",
            "city": "RAVENNA",
            "state": "MI",
            "postal_code": "49451",
            "telephone_number": "231-853-2954",
            "fax_number": "231-853-6089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KELLEY",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704210304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Resfeber Therapy
• Robert D & Cindy L Douglas
• Karen Danielle Rubin-Fortier, LPC
• Emma Swanson, ATC, LAT
• Alisha Lewise Warner, CENA/HOME HEALTH AID

• Family Nurse Practitioner in Ravenna, MI
• Providers in Ravenna, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.