Individual provider Active NPI

Kelley Dawn Dyer, CNM

  • Advanced Practice Midwife
  • Bellefontaine, OH
National Provider Identifier
1760502504
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
NM07070 Issued in OH
Practice address
110 Dowell Ave
Bellefontaine, OH 43311-2305
Phone
(937) 599-3538
Fax
(937) 599-4712
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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 NM07070 OH Primary

Addresses

Primary practice location

110 Dowell Ave
Bellefontaine, OH 43311-2305

Mailing address

110 Dowell Ave
Bellefontaine, OH 43311-2305
Phone (937) 599-3538

Other identifiers 1

IdentifierTypeStateIssuer
2440835MedicaidOH

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
I20240918000904 MI Practitioner - Certified Nurse Midwife (CNM) 8820284342 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NM07070OHMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Michigan, PC CurrentSince Aug 1, 2024 Accepting new patients
Mary Rutan Hospital Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607
Phone (864) 908-3736

Interoperability endpoints

  • Direct secure messaging: kdyer845784@direct.hfhs.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1760502504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 DOWELL AVE",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112305",
            "telephone_number": "937-599-3538",
            "fax_number": "937-599-4712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 DOWELL AVE",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112305",
            "telephone_number": "937-599-3538",
            "fax_number": "937-599-4712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "KELLEY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OH",
            "license": "NM07070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2440835",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellefontaine, OH

Sources for this page

Verify at the official NPI Registry.