KELLY J CULMORE (DNP) – Psychiatry Physician, NPI 1841760972

KELLY J CULMORE (DNP) is a healthcare provider. based in Grand rapids, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP. They hold a License No. 4707345167 (MI). The NPI Number for KELLY J CULMORE (DNP) is 1841760972

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
KELLY J CULMORE (DNP)
NPI
1841760972
Phone
(616) 957-2235
Address
1055 MEDICAL PARK DR SE
Enumeration Date
2 December 2018
Last Update Date
20 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6169579112
Graduation Year
2018 (8 years ago)
PAC ID
9537555727
Group Practice PAC ID
6608826557
Professional Enrollment ID
I20220418000382
Address ID
MI495463663GR1000XSEXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:7State licenses:1Digital endpointsOther names

8,106 NURSE PRACTITIONER in MI

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Provider Addresses for KELLY J CULMORE (DNP)

  • 1055, Medical Park Drive Southeast, Eastmont, Grand Rapids Charter Township, Kent County, Michigan, 49546, United States

    GRAND RAPIDS, MI 495463607

    Phone: (616) 957-2235

    Type: Location

  • 1625 E Jefferson Blvd

    Mishawaka, IN 465457103

    Phone: (269) 487-7289

    Type: Location

  • 1353, Cedar Court, Niles, Berrien County, Michigan, 49120, United States

    NILES, MI 491202138

    Phone: (269) 487-7289

    Type: Mailing

  • 1474 HIGHVIEW DR SE

    BYRON CENTER, MI 493158171

    Phone: (269) 487-7289

    Type: Mailing

  • 1000 PARCHMENT DR SE

    GRAND RAPIDS, MI 495463663

    Phone: (616) 957-9112

    Type: Location

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: 2022-04-18

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
I20220418000382INurse PractitionerMITBD

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 49546)

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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: 6608826557View full group profile
NameSpecialtyState
Clinical PsychologistMI
-MI
Clinical Social WorkerMI
-MI
Clinical PsychologistMI
-MI
Clinical Social WorkerMI
Clinical PsychologistIL
Clinical Social WorkerIL
Clinical PsychologistMI

Reviews

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Frequently asked questions

What identifier follows KELLY J CULMORE (DNP) across health systems?
The NPI 1841760972 uniquely identifies KELLY J CULMORE (DNP) in U.S. healthcare data.
Quick check: is KELLY J CULMORE (DNP) active?
Public NPPES data shows KELLY J CULMORE (DNP) with an active NPI status right now.
Which specialty label fits KELLY J CULMORE (DNP)?
NPPES ties KELLY J CULMORE (DNP) to Psychiatry Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to KELLY J CULMORE (DNP)?
KELLY J CULMORE (DNP) shows a connection to Grand Rapids, Michigan in registry-derived data.
Who maintains KELLY J CULMORE (DNP)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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