Individual provider Active NPI

Kellie D Sanders-Kizer, M.D.

  • Family Medicine Physician
  • Three Rivers, MI
National Provider Identifier
1972612174
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301067929 Issued in MI
Practice address
1241 W Broadway St
Three Rivers, MI 49093-8319
Phone
(269) 273-9539
NPI assigned
Aug 30, 2006
Last updated
May 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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 4301067929 MI Primary

Addresses

Primary practice location

1241 W Broadway St
Three Rivers, MI 49093-8319

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Other practice location 1

8500 14th St
Detroit, MI 48206-2425
Phone (313) 894-3950

Other practice location 2

633 S Erie St
Three Rivers, MI 49093-2073
Phone (269) 273-9539

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
I20041222000145 MI Practitioner - Family Practice 1658339650 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians

Practice addresses (Care Compare)

1241 W Broadway St
Three Rivers, MI 49093-8319
Phone (269) 273-9539

1555 E Chicago Rd
Sturgis Medical Group Primary Care
Sturgis, MI 49091-1993
Phone (269) 381-3963

7901 Angling Rd
Portage, MI 49024-0714

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301067929MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Dowagiac, Inc CurrentSince Sep 22, 2025 Accepting new patients
Beacon Dowagiac, Inc CurrentSince Sep 22, 2025 Accepting new patients
Promed Healthcare CurrentSince Oct 14, 2019 Accepting new patients
Beacon Medical Group Michigan Inc Family Medicine CurrentSince Oct 14, 2019 Accepting new patients
Betts Medical Group LLC Past Accepting new patients

Locations

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

420 W High St
Dowagiac, MI 49047
Phone (269) 782-8681

520 Main St
Ste A
Dowagiac, MI 49047
Phone (269) 783-3052

1717 Shaffer St
Ste 002
Kalamazoo, MI 49048

1717 Shaffer St
Ste 2
Kalamazoo, MI 49048

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

1555 E Chicago Rd
Sturgis, MI 49091
Phone (269) 651-7114

1717 E Chicago Rd
Ste 2
Sturgis, MI 49091
Phone (269) 651-1471

600 S Lakeview Ave
Ste B04
Sturgis, MI 49091
Phone (269) 659-4317

916 Myrtle St
Sturgis, MI 49091
Phone (269) 651-7824

1241 W Broadway St
Three Rivers, MI 49093
Phone (269) 273-9539

633 S Erie St
Three Rivers, MI 49093
Phone (269) 273-8557

Organizations & group practices 6

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 4

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1972612174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 W BROADWAY ST",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938319",
            "telephone_number": "269-273-9539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8500 14th St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482062425",
            "country_code": "US",
            "telephone_number": "313-894-3950",
            "fax_number": "313-894-1729",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "633 S Erie St",
            "address_purpose": "LOCATION",
            "city": "Three Rivers",
            "state": "MI",
            "postal_code": "490932073",
            "country_code": "US",
            "telephone_number": "269-273-9539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS-KIZER",
        "first_name": "KELLIE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301067929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Three Rivers, MI

Sources for this page

Verify at the official NPI Registry.