Individual provider Active NPI

Kelsee Amber Vanderbaan, NP

  • Family Nurse Practitioner
  • Wyoming, MI
National Provider Identifier
1497270524
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704306404 Issued in MI
Practice address
6105 Wilson Ave SW Ste 202
Wyoming, MI 49418-9714
Phone
(616) 486-5299
NPI assigned
Aug 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704306404 MI Primary

Addresses

Primary practice location

6105 Wilson Ave SW Ste 202
Wyoming, MI 49418-9714

Mailing address

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

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171011002441 MI Practitioner - Nurse Practitioner 8820363229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

10383 42ND Ave
Allendale, MI 49401-8207

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Corewell Health Zeeland Hospital Hospital, Zeeland, MI, CCN 230003
  • Corewell Health Pennock Hospital Hospital, Hastings, MI, CCN 231339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Oct 15, 2017 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Oct 15, 2017 Accepting new patients

Locations

15100 Whittaker Way
Grand Haven, MI 49417
Phone (616) 935-6200

426 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 267-7888

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

4069 Lake Dr SE
Grand Rapids, MI 49546
Phone (616) 267-7469

4075 32nd Ave
Hudsonville, MI 49426
Phone (616) 229-9310

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

6105 Wilson Ave SW
Ste 202
Wyoming, MI 49418
Phone (616) 486-5299

6105 Wilson Ave SW
Wyoming, MI 49418
Phone (616) 486-5055

Interoperability endpoints

  • Direct secure messaging: kvanderbaan118829@epic00.corewelldirect.org

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1497270524",
    "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": "6105 WILSON AVE SW STE 202",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "494189714",
            "telephone_number": "616-486-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERBAAN",
        "first_name": "KELSEE",
        "middle_name": "AMBER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-09",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704306404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.