Individual provider Active NPI

Erin Marie Kevern, D.O.

  • Otolaryngology Physician
  • Mishawaka, IN
National Provider Identifier
1902245194
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
5101020418 Issued in MI
Practice address
810 Park PL
Mishawaka, IN 46545-3520
Phone
(574) 366-0240
NPI assigned
Jun 20, 2013
Last updated
Feb 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 02005351A IN
Otolaryngology Physician 207Y00000X 5101020418 MI Primary

Addresses

Primary practice location

810 Park PL
Mishawaka, IN 46545-3520

Mailing address

710 N Niles Ave
South Bend, IN 46617-1924
Phone (574) 647-1610

Other practice location 1

1425 Michigan St NE
Grand Rapids, MI 49503-2027
Phone (616) 459-4514

Other practice location 2

100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone (616) 391-9000

Other practice location 3

6913 N Main St Ste 200
Granger, IN 46530-8039
Phone (574) 647-4540

Other identifiers 1

IdentifierTypeStateIssuer
300014225MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180710000924 IN Practitioner - Otolaryngology 8628210226 Reassigns benefits to 1 organization
I20231003003420 MI Practitioner - Otolaryngology 8628210226 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Michigan State University College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Ear Nose Throat and Allergy Specialists PCGroup PAC ID 4183868094, 42 clinicians
Exhale Sinus Indiana Clinics LLCGroup PAC ID 1254834088, 3 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

1425 Michigan St NE
Suite a
Grand Rapids, MI 49503-2027
Phone (616) 459-4514

1840 Wealthy St SE
Corewell Health Medical Group West
Grand Rapids, MI 49506-2921
Phone (616) 885-5000

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

810 Park PL
Mishawaka, IN 46545-3520
Phone (574) 366-0240

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101020418MIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Jan 1, 2026 Accepting new patients
Exhale Sinus Indiana Clinics LLC Otolaryngology CurrentSince Dec 23, 2025 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 1, 2026 Accepting new patients
Michigan Ear, Nose, Throat, and Allergy Specialists, PC CurrentSince Jun 2, 2025 Accepting new patients

Locations

810 Park Pl
Mishawaka, IN 46545
Phone (574) 336-0240

11160 Wj Presley Pkwy
Allendale, MI 49401
Phone (616) 252-3900

11160 Wj Presley Pkwy
Ste 102
Allendale, MI 49401
Phone (616) 384-2810

705 Oak St
Big Rapids, MI 49307
Phone (231) 592-4356

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

1425 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 233-0933

1425 Michigan St NE
Ste A
Grand Rapids, MI 49503
Phone (616) 233-0933

1005 W Green St
Ste 101
Hastings, MI 49058
Phone (616) 797-8569

3100 N Wellness Dr
Holland, MI 49424
Phone (616) 396-1433

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

1555 44th St SW
Wyoming, MI 49509
Phone (616) 249-8000

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1902245194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 PARK PL",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453520",
            "telephone_number": "574-366-0240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 Michigan St NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032027",
            "country_code": "US",
            "telephone_number": "616-459-4514",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Michigan St NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032560",
            "country_code": "US",
            "telephone_number": "616-391-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6913 N Main St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Granger",
            "state": "IN",
            "postal_code": "465308039",
            "country_code": "US",
            "telephone_number": "574-647-4540",
            "fax_number": "574-647-2567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEVERN",
        "first_name": "ERIN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "02005351A",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "5101020418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300014225",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.