Individual provider Active NPI

Kenneth L. Colton, D.O.

  • Family Medicine Physician
  • Westland, MI
National Provider Identifier
1053479154
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101009187 Issued in MI
Practice address
400 N Wayne Rd
Westland, MI 48185-3628
Phone
(734) 522-7000
Fax
(734) 522-7012
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101009187 MI Primary

Addresses

Primary practice location

400 N Wayne Rd
Westland, MI 48185-3628

Mailing address

400 N Wayne Rd
Westland, MI 48185-3628
Phone (734) 522-7000

Other identifiers 3

IdentifierTypeStateIssuer
080H225910OtherMIBCN PROVIDER NUMBER
4331440MedicaidMI
080H225910OtherMIBCBS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051019000157 MI Practitioner - Family Practice 8729004981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City College of Medicine and Surgery, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
VMD Primary Providers Eastern Michigan PCGroup PAC ID 9234480575, 63 clinicians

Practice addresses (Care Compare)

400 N Wayne Rd
Michigan Family Physicians
Westland, MI 48185-3628
Phone (734) 522-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101009187MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VMD Primary Providers Eastern Michigan, PC Family Medicine CurrentSince Mar 1, 2021 Accepting new patients

Locations

39475 Lewis Dr
Ste 130
Novi, MI 48377
Phone (248) 374-0502

400 N Wayne Rd
Westland, MI 48185
Phone (734) 522-7000

400 N Wayne Rd
Ste 500
Westland, MI 48185

Interoperability endpoints

  • Direct secure messaging: kenneth.colton.1@21803.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1053479154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N WAYNE RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481853628",
            "telephone_number": "734-522-7000",
            "fax_number": "734-522-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N WAYNE RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481853628",
            "telephone_number": "734-522-7000",
            "fax_number": "734-522-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLTON",
        "first_name": "KENNETH",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101009187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN PROVIDER NUMBER",
            "identifier": "080H225910",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4331440",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "080H225910",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westland, MI

Sources for this page

Verify at the official NPI Registry.