Individual provider Active NPI

Kylie Marie Dunn

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1861295685
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601013398 Issued in MI
Practice address
1049 Jackson St NW
Grand Rapids, MI 49504-5481
Phone
(616) 254-9944
NPI assigned
Mar 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601013398 MI Primary

Addresses

Primary practice location

1049 Jackson St NW
Grand Rapids, MI 49504-5481

Mailing address

1049 Jackson St NW
Grand Rapids, MI 49504-5481
Phone (616) 254-9944

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
I20260109000152 MI Practitioner - Physician Assistant 8224514211 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Michigan Emergency Specialists, PLLCGroup PAC ID 0749569242, 36 clinicians
Lake Michigan Observation Services PLLCGroup PAC ID 3375938889, 30 clinicians

Practice addresses (Care Compare)

1500 E Sherman Blvd
Mercy Campus
Muskegon, MI 49444-1849
Phone (231) 728-4601

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601013398MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Michigan Observation Services PLLC CurrentSince Nov 24, 2025 Accepting new patients
Lake Michigan Emergency Specialists, PLLC CurrentSince Nov 24, 2025 Accepting new patients

Locations

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

72 S State St
Shelby, MI 49455
Phone (231) 728-4601

Interoperability endpoints

  • Direct secure messaging: kdunn3852491@direct.trinity-health.org

Organizations & group practices 2

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 1

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": "1743120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1861295685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 JACKSON ST NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045481",
            "telephone_number": "616-254-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 JACKSON ST NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045481",
            "telephone_number": "616-254-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNN",
        "first_name": "KYLIE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-28",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601013398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.