Active NPI
Kennedy Pratt
- Physician Assistant
- Kalamazoo, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601013581
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427848407 | Medicaid | MI |
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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5601013581 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascension Medical Group Promed | Current | Accepting new patients | |
| Promed Healthcare | Current | 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.
-
- Family Medicine Physician
- Portage, MI
- NPI 1497709869
-
- Internal Medicine Physician
- Kalamazoo, MI
- NPI 1720009954
-
- Rural Health Clinic/Center
- Plainwell, MI
- NPI 1487708830
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Kalamazoo, MI
- NPI 1568416311
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.