Faith Yung Min Kelley, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704288216 Issued in MI

Practice address

148 W Parkdale Ave
Manistee, MI 49660-1128

Phone

(231) 398-2258

NPI assigned

Nov 24, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Faith Yung Min Miller Other name

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Northwest Michigan Health Services Inc.

  • Federally Qualified Health Center (FQHC)
  • Shelby, MI
  • NPI 1235208075
  NPD (past)
• Northwest Michigan Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Traverse City, MI
  • NPI 1144645250
  NPD (past)
• Northwest Michigan Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Shelby, MI
  • NPI 1306262258
  NPD (past)

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

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1942804562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9802 W 16 RD",
            "city": "MESICK",
            "state": "MI",
            "postal_code": "496689782",
            "telephone_number": "231-920-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 W PARKDALE AVE",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496601128",
            "telephone_number": "231-398-2258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "FAITH",
        "middle_name": "YUNG MIN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-24",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4704288216",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704288216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FAITH",
            "last_name": "MILLER",
            "middle_name": "YUNG MIN",
            "credential": "N/A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Holly Joseph
• Justin P Terry DDS PLLC
• Nicole Kanomata, FNP
• Charles Joseph Keil, O.D.
• Michael Keith
• Kenneth a Borenitsch D O P C
• Jesse Leah Keson, FNP
• Bryan Keith Kidd, PT
• Gracie Kierczynski
• Kimberly S Anderson DC PLC

• Family Nurse Practitioner in Manistee, MI
• Providers in Manistee, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.