Active NPI
Kyle Griffin, DMSC, PA-C, MPH, ATC
- Physician Assistant
- Gaylord, MI
National Provider Identifier
1396290185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601010798
- Practice address
- 2782 S Otsego Ave
Gaylord, MI 49735-9404 - Phone
- (989) 732-7525
- NPI assigned
- Aug 22, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 0126002598 | VA | |
| Physician Assistant | 363A00000X | 5601010798 | MI | Primary |
Addresses
Primary practice location
2782 S Otsego Ave
Gaylord, MI 49735-9404
Mailing address
2782 S Otsego Ave
Gaylord, MI 49735-9404
Phone (899) 732-7525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0126002598 | VA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752883200000",
"number": "1396290185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2782 S OTSEGO AVE",
"city": "GAYLORD",
"state": "MI",
"postal_code": "497359404",
"telephone_number": "899-732-7525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2782 S OTSEGO AVE",
"city": "GAYLORD",
"state": "MI",
"postal_code": "497359404",
"telephone_number": "989-732-7525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIFFIN",
"first_name": "KYLE",
"credential": "DMSC, PA-C, MPH, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-22",
"last_updated": "2025-07-19",
"certification_date": "2025-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "VA",
"license": "0126002598",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601010798",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaylord, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.