Individual provider Active NPI

Kimberly Sue Devlin, D.O.

  • Family Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1891014569
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101018649 Issued in MI
Practice address
75 Sheldon Ave SE Ste 101
Grand Rapids, MI 49503-4224
Phone
(616) 391-2420
NPI assigned
May 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101018649 MI Primary

Addresses

Primary practice location

75 Sheldon Ave SE Ste 101
Grand Rapids, MI 49503-4224

Mailing address

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

Other practice location 1

1445 Sheldon Rd
Suite 201
Grand Haven, MI 49417-2480
Phone (616) 846-8540

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Kimberly.Devlin@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130924000952 MI Practitioner - Family Practice 1254312895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

75 Sheldon Ave SE
100 Corewell Health Medical Group West
Grand Rapids, MI 49503-4224
Phone (616) 391-6120

75 Sheldon Blvd
101 Corewell Health Medical Group West
Grand Rapids, MI 49503-4224
Phone (616) 391-2420

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Sep 3, 2013 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 17, 2021 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Sep 3, 2013 Accepting new patients

Locations

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

1445 Sheldon Rd
Ste 201
Grand Haven, MI 49417
Phone (616) 842-3250

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

75 Sheldon Ave SE
Ste 101
Grand Rapids, MI 49503
Phone (616) 391-2420

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

Interoperability endpoints

  • Direct secure messaging: kdevlin84291@epic00.corewelldirect.org
  • Direct secure messaging: kimberly.devlin@epic00.shdirect.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.

Hospital & facility affiliations 2

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": "1274313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1891014569",
    "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": "75 SHELDON AVE SE STE 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034224",
            "telephone_number": "616-391-2420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1445 Sheldon Rd",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Grand Haven",
            "state": "MI",
            "postal_code": "494172480",
            "country_code": "US",
            "telephone_number": "616-846-8540",
            "fax_number": "616-846-5619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVLIN",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-20",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101018649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kimberly.Devlin@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "75 Sheldon Ave SE Ste 101",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495034224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "75 Sheldon Ave SE Ste 101",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495034224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.