KENEDY M SHELTON
NPI 1093329203
Social Worker in Holland, MI

Q: What is Kenedy Shelton's NPI number?

The NPI number for Kenedy Shelton is 1093329203. It was assigned to this individual provider in the NPPES registry on September 4, 2020.

Q: What is Kenedy Shelton's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Kenedy Shelton was last updated on November 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 04, 2020PECOS Enrolled

412 CENTURY LN, HOLLAND, MI 49423(616) 396-2301 Get Directions Write a Review

NPPES record last updated: November 5, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 5, 2025, Sep 4, 2020 (2 updates tracked since 2020).

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About Kenedy M Shelton NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENEDY M SHELTON (NPI 1093329203) is an individual social worker in Holland, Michigan and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093329203

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameKENEDY M SHELTON

Location Address412 CENTURY LNHolland, MI 49423-4285

Mailing Address3333 Butternut DrHolland, MI 49424-5968 · (616) 337-4660

Phone(616) 396-2301

Sole ProprietorNo

Enumeration DateSeptember 4, 2020

Last NPPES UpdateNovember 5, 20252 updates tracked since enumeration

NPPES CertifiedNovember 5, 2025

✔ NPI 1093329203 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

412 CENTURY LN, Holland, MI 49423

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenedy M Shelton is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY FAITH JOHNSON

Social Worker