Individual provider Active NPI

Cynthia-Mendon Kelrick, CNM

  • Advanced Practice Midwife
  • Saint Joseph, MI
National Provider Identifier
1407499908
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
4704312736 Issued in MI
Practice address
3950 Hollywood Rd Ste 100
Saint Joseph, MI 49085-9151
Phone
(269) 429-8010
Fax
(269) 408-0986
NPI assigned
Oct 28, 2019
Last updated
Oct 28, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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 4704312736 MI Primary

Addresses

Primary practice location

3950 Hollywood Rd Ste 100
Saint Joseph, MI 49085-9151

Mailing address

3950 Hollywood Rd Ste 100
Saint Joseph, MI 49085-9151
Phone (269) 429-8010

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
I20200110002593 MI Practitioner - Certified Nurse Midwife (CNM) 9931534492 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

3950 Hollywood Rd
Saint Joseph, MI 49085-9151
Phone (269) 429-0900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Intercare Community Health Network CurrentSince Feb 7, 2020 Accepting new patients
Intercare Community Health Network CurrentSince Feb 7, 2020 Accepting new patients
Lakeland Medical Practices CurrentSince Nov 27, 2019 Accepting new patients
Lakeland Medical Practices CurrentSince Nov 27, 2019 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc Past Accepting new patients

Locations

308 Charles St
Bangor, MI 49013
Phone (269) 427-7967

50 Industrial Park Rd
Bangor, MI 49013
Phone (269) 427-7937

800 M 139
Benton Harbor, MI 49022
Phone (269) 927-5400

870 Colfax Ave
Benton Harbor, MI 49022
Phone (269) 605-1277

7450 Hochberger Rd
Eau Claire, MI 49111
Phone (855) 869-6900

285 James St
Holland, MI 49424
Phone (616) 399-0200

538 Washington St
Otsego, MI 49078
Phone (269) 694-7873

5498 109th Ave
Pullman, MI 49450
Phone (269) 236-5021

3950 Hollywood Rd
Ste 100
Saint Joseph, MI 49085
Phone (269) 429-0900

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

Interoperability endpoints

  • Direct secure messaging: ckelrick1270254@epic00.corewelldirect.org
  • Direct secure messaging: cynthiamendon.kelrick@ichn.eclinicaldirectplus.com

Organizations & group practices 5

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": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1407499908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD STE 100",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859151",
            "telephone_number": "269-429-8010",
            "fax_number": "269-408-0986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD STE 100",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859151",
            "telephone_number": "269-429-8010",
            "fax_number": "269-408-0986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELRICK",
        "first_name": "CYNTHIA-MENDON",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704312736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.