Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kellie Lea Mumford, PA-C

Individual provider Physician Assistant · NPI 1346496759

Kellie Lea Mumford, PA-C is a Physician Assistant in Gaylord, Michigan. Qualified in 2008, 18 years ago. Practices with Great Lakes Orthopaedic Center PC, a 37-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
18
Licensed in
MI
In the registry since
2008
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2147 Professional Dr
Gaylord, MI 49735-0003
Phone: (989) 732-1753
Fax: (989) 731-1425
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601005363 (MI)

Record details

NPI number1346496759
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 18, 2008
Last updated in NPPESDecember 23, 2020
Certification dateDecember 23, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Great Lakes Orthopaedic Center Pc — 37 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Gaylord