Kenneth F Shockley, D.O.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

5101010606 Issued in MI

Practice address

4047 E Hills CT SE
Grand Rapids, MI 49546-6249

Phone

(616) 956-9577

Fax

(616) 956-5988

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Urology

Education

Philadelphia College of Osteopathic Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Institute of Urology PCGroup PAC ID 1052223492, 82 clinicians

Metropolitan HospitalGroup PAC ID 5597651836, shared by 3 NPIs, 421 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236
• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/uc29598_michiganurologicalclinic

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.

• Alliance Physician Services of Michigan, P.C.

  • Urology Physician
  • St Clair Shores, MI
  • NPI 1427027416
  Medicare reassignment Care Compare group NPD
• Metropolitan Hospital

  • Hematology & Oncology Physician
  • Wyoming, MI
  • NPI 1487813200
  Medicare reassignment NPD
• Metropolitan Hospital

  • Internal Medicine Physician
  • Wyoming, MI
  • NPI 1811937519
  Medicare reassignment NPD
• Metropolitan Hospital

  • Family Medicine Physician
  • Wyoming, MI
  • NPI 1114947538

  Urology

  NPD
• Michigan Institute of Urology PC

  • Durable Medical Equipment & Medical Supplies
  • Utica, MI
  • NPI 1922999051

  Urology

  NPD
• Michigan Urological Clinic

  • Urology Physician
  • Grand Rapids, MI
  • NPI 1376586164
  NPD

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

• Metropolitan Hospital

  • General Acute Care Hospital
  • Wyoming, MI
  • NPI 1619923919
  Care Compare affiliation
• Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Hospitals

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1801854039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD STE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813203",
            "telephone_number": "586-771-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4047 E HILLS CT SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466249",
            "telephone_number": "616-956-9577",
            "fax_number": "616-956-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCKLEY",
        "first_name": "KENNETH",
        "middle_name": "F",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "5101010606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3153602",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Shipton, D.D.S
• Brooke Marianna Shirley
• Laura Rae Shirley, CNP
• Renell Shisha, DO
• Muhammad Shoaib, M.D.
• Christopher R Shoemaker, MD
• Dale R Shoemaker, D.D.S.
• Kylynn Shoemaker
• Leigh Kelly Shoemaker, M.S., PA-C
• Michael James Shoemaker, PT, DPT, PHD

• Urology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Urology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.

Verify at the official NPI Registry.