Individual provider Active NPI

Kennedy Pratt

  • Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1427848407
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601013581 Issued in MI
Practice address
1722 Shaffer St
Kalamazoo, MI 49048-1633
Phone
(269) 381-3963
NPI assigned
May 12, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601013581 MI Primary

Addresses

Primary practice location

1722 Shaffer St
Kalamazoo, MI 49048-1633

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Other practice location 1

22408 Township Road 275
Alvada, OH 44802-9606
Phone (419) 348-3298

Other identifiers 1

IdentifierTypeStateIssuer
1427848407MedicaidMI

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260318000221 MI Practitioner - Physician Assistant 0648754713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians

Practice addresses (Care Compare)

1722 Shaffer St
Suite 1
Kalamazoo, MI 49048-1633
Phone (269) 381-3963

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601013581MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Promed CurrentSince Mar 8, 2026 Accepting new patients
Promed Healthcare CurrentSince Mar 8, 2026 Accepting new patients
Ascension Medical Group Promed Past Accepting new patients

Locations

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

1722 Shaffer St
Ste 1
Kalamazoo, MI 49048
Phone (269) 381-3963

1722 Shaffer St
Kalamazoo, MI 49048
Phone (269) 226-5600

Organizations & group practices 3

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

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": "1747008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1427848407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 SHAFFER ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481633",
            "telephone_number": "269-381-3963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22408 Township Road 275",
            "address_purpose": "LOCATION",
            "city": "Alvada",
            "state": "OH",
            "postal_code": "448029606",
            "country_code": "US",
            "telephone_number": "419-348-3298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRATT",
        "first_name": "KENNEDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-12",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601013581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427848407",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.