Active NPI
Beth A Kelley, NP, CNM
- Advanced Practice Midwife
- Sturgis, MI
National Provider Identifier
1972724821
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 4704194227
- Practice address
- 1717 E. Chicago Road
Sturgis, MI 49091-2372 - Phone
- (269) 659-6747
- Fax
- (269) 659-6746
- NPI assigned
- May 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704194227 | MI | |
| Family Nurse Practitioner | 363LF0000X | 4704194227 | MI | |
| Advanced Practice Midwife | 367A00000X | 4704194227 | MI | Primary |
Addresses
Primary practice location
1717 E. Chicago Road
Sturgis, MI 49091-2372
Mailing address
1717 E Chicago Rd
Sturgis, MI 49091-8524
Phone (269) 659-6747
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000612032 | Other | IN | BCBS |
| 200932840 | Medicaid | IN | |
| 160G510560 | Other | MI | BCBS GROUP-WOMENS SERVICES |
| 700G560080 | Other | MI | BCBS GROUP-THREE RIVERS HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704194227 | MI | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354752000000",
"number": "1972724821",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 E CHICAGO RD",
"city": "STURGIS",
"state": "MI",
"postal_code": "490918524",
"telephone_number": "269-659-6747",
"fax_number": "269-659-6746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 E. CHICAGO ROAD",
"city": "STURGIS",
"state": "MI",
"postal_code": "490912372",
"telephone_number": "269-659-6747",
"fax_number": "269-659-6746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "BETH",
"middle_name": "A",
"credential": "NP, CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2012-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704194227",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704194227",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "MI",
"license": "4704194227",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "000000612032",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200932840",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GROUP-WOMENS SERVICES",
"identifier": "160G510560",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GROUP-THREE RIVERS HEALTH",
"identifier": "700G560080",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sturgis, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.