KELSI LYNN CHURCHILL – Audiologist, NPI 1609609411

KELSI LYNN CHURCHILL is a healthcare provider. based in Petoskey, Michigan. specializing in QUALIFIED AUDIOLOGIST. They hold a License No. 1601001168 (MI). The NPI Number for KELSI LYNN CHURCHILL is 1609609411

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
KELSI LYNN CHURCHILL
NPI
1609609411
Phone
Not provided
Address
1114 CHARLEVOIX AVE
Enumeration Date
26 August 2024
Last Update Date
26 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2314898151
Graduation Year
2024 (2 years ago)
PAC ID
4385185149
Group Practice PAC ID
6002179835
Professional Enrollment ID
I20240919002583
Address ID
MI497709701PE1114XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

302 QUALIFIED AUDIOLOGIST in MI

Provider Addresses for KELSI LYNN CHURCHILL

  • 1114 CHARLEVOIX AVE

    PETOSKEY, MI 497709701

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-09-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240919002583IQualified AudiologistMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49770)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002179835View full group profile
NameSpecialtyState
Physician AssistantMI
-MI
Qualified AudiologistMI
Qualified AudiologistMI
O T O L A R Y N G O L O G YMI
Nurse PractitionerMI
Nurse PractitionerMI

Reviews

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Frequently asked questions

What is the registry number for KELSI LYNN CHURCHILL?
The registry entry for KELSI LYNN CHURCHILL shows NPI 1609609411.
Does the public listing show KELSI LYNN CHURCHILL as active?
KELSI LYNN CHURCHILL's NPI record reflects an active status in NPPES.
What type of care does KELSI LYNN CHURCHILL provide?
KELSI LYNN CHURCHILL's profile centers on Audiologist. Clinical services aligned with this taxonomy classification.
Can patients visit KELSI LYNN CHURCHILL in Petoskey, Michigan?
For routing, start with Petoskey, Michigan for KELSI LYNN CHURCHILL, then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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