Individual provider Active NPI

Kelly Walker, N.P.

  • Family Nurse Practitioner
  • Kalamazoo, MI
National Provider Identifier
1659761054
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704309024 Issued in MI
Practice address
6220 W Main St
Kalamazoo, MI 49009-8925
Phone
(269) 276-4744
Fax
(269) 353-5856
NPI assigned
Jan 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 4704309024 MI Primary

Addresses

Primary practice location

6220 W Main St
Kalamazoo, MI 49009-8925

Mailing address

17335 Oleander Ave
Tinley Park, IL 60477-3226
Phone (708) 710-0737

Other practice location 1

8683 Red Arrow Hwy
Watervliet, MI 49098-9761
Phone (369) 463-3375

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

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
I20150305000136 MI Practitioner - Nurse Practitioner 0648596981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

5629 Stadium Dr B
Kalamazoo, MI 49009-1952
Phone (269) 544-3270

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital CurrentSince Nov 9, 2017 Accepting new patients

Locations

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

6220 W Main St
Kalamazoo, MI 49009
Phone (269) 276-4744

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

6938 Elm Valley Dr
Ste 101
Kalamazoo, MI 49009
Phone (269) 552-4167

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

5629 Stadium Dr
Ste B
Kalamazoo, MI 49009
Phone (269) 544-3270

Interoperability endpoints

  • Direct secure messaging: kwalker95196@direct.bronsonhg.org
  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 1

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": "1421971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1659761054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17335 OLEANDER AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773226",
            "telephone_number": "708-710-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6220 W MAIN ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490098925",
            "telephone_number": "269-276-4744",
            "fax_number": "269-353-5856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8683 Red Arrow Hwy",
            "address_purpose": "LOCATION",
            "city": "Watervliet",
            "state": "MI",
            "postal_code": "490989761",
            "country_code": "US",
            "telephone_number": "369-463-3375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "KELLY",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-23",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704309024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.