Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kellyann Vandendool, MD

Individual provider Surgery Physician · NPI 1366797615

Kellyann Vandendool, MD is a General Surgery in Ludington, Michigan. Qualified in 2012, 14 years ago. Practices with Memorial Medical Center of West Michigan, a 60-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
14
Licensed in
MI
In the registry since
2012
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

7 Atkinson Dr Ste 200
Ludington, MI 49431-1917
Phone: (231) 843-3717
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 4301111681 (MI)

Record details

NPI number1366797615
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 23, 2012
Last updated in NPPESFebruary 16, 2021
Certification dateFebruary 16, 2021
Mailing address100 Michigan St Ne # Mc845, Grand Rapids, MI 49503-2560

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Memorial Medical Center Of West Michigan — 60 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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