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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

KELLY THEAKER RN
NPI 1528964350
Registered Nurse in Rockford, MI

Active since October 19, 2026
4100 KROES ST NE, ROCKFORD, MI 49341(616) 863-6031(616) 866-5997 Get Directions Write a Review

NPPES record added: October 19, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kelly Theaker Rn NPPES

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

KELLY THEAKER RN (NPI 1528964350) is an individual registered nurse in Rockford, Michigan, licensed in Michigan (4704257491) and active in the NPI registry since October 2026.

NPPES Registry Identity

NPI1528964350
Entity TypeIndividualFemale
Primary Taxonomy163W00000X
Provider Legal NameKELLY THEAKERCredential: RN
Location Address4100 KROES ST NERockford, MI 49341-9295
Mailing Address4100 Kroes St NeRockford, MI 49341-9295 · (616) 863-6031 · Fax (616) 866-5997
Phone(616) 863-6031
Fax(616) 866-5997
Sole ProprietorYes
Enumeration DateOctober 19, 2026
NPPES CertifiedOctober 18, 2026
✔ NPI 1528964350 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered NurseNursing Service Providers
Taxonomy Code163W00000X
License✔ Licensed in MI · 4704257491
Definition
(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.
4100 KROES ST NE, Rockford, MI 49341
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Other Providers at the Same Location NPPES 2

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

SPECTRUM HEALTH PRIMARY CARE PARTNERS
Social Worker
4100 KROES ST NE
ROCKFORD, MI 49341
Kent County (616) 754-6185
TAYLOR BAKER
Specialist/Technologist (Athletic Trainer)
4100 KROES ST NE
ROCKFORD, MI 49341
Kent County (616) 824-8135

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Theaker's NPI number?

The NPI number for Kelly Theaker is 1528964350. It was assigned to this individual provider in the NPPES registry on October 19, 2026.

Where is Kelly Theaker located?

Kelly Theaker practices at 4100 Kroes St NE, Rockford, MI 49341. The listed phone number is (616) 863-6031.

What is Kelly Theaker's specialty?

The primary specialty registered for this NPI is Registered Nurse with taxonomy code 163W00000X.

When was this NPI record last updated?

The NPPES record for Kelly Theaker was last updated on October 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days 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.