Individual provider Active NPI

Kendal Leigh Griffith, PA-C

  • Physician Assistant
  • Celebration, FL
National Provider Identifier
1881347045
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9115336 Issued in FL
Practice address
410 Celebration PL Ste 305
Celebration, FL 34747-5436
Phone
(407) 303-4120
NPI assigned
Jan 28, 2022
Last updated
Oct 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.008896 IL
Physician Assistant 363A00000X PA9115336 FL Primary

Addresses

Primary practice location

410 Celebration PL Ste 305
Celebration, FL 34747-5436

Mailing address

410 Celebration PL Ste 305
Celebration, FL 34747-5436
Phone (407) 303-4120

Other practice location 1

360 W Butterfield Rd Ste 160
Elmhurst, IL 60126-5099
Phone (630) 782-9600

Other practice location 2

1200 S York St Ste 2000
Elmhurst, IL 60126-5634
Phone (331) 221-9004

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kgriffith245902@direct.edward.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20231031000207 FL Practitioner - Physician Assistant 6406243294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

400 Celebration PL
Celebration, FL 34747-4970

410 Celebration PL
Celebration, FL 34747-5436

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.008896ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Nov 6, 2023 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Nov 6, 2023 Accepting new patients

Locations

410 Celebration Pl
Ste 305
Kissimmee, FL 34747
Phone (407) 303-4120

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kendalgriffith@osscil.allscriptsdirect.net
  • Direct secure messaging: kgriffith2040481@adventhealth.direct-ci.com

Organizations & group practices 2

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 2

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": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1881347045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL STE 305",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475436",
            "telephone_number": "407-303-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL STE 305",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475436",
            "telephone_number": "407-303-4120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 W Butterfield Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "IL",
            "postal_code": "601265099",
            "country_code": "US",
            "telephone_number": "630-782-9600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 S York St Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "IL",
            "postal_code": "601265634",
            "country_code": "US",
            "telephone_number": "331-221-9004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIFFITH",
        "first_name": "KENDAL",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-28",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.008896",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgriffith245902@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1200 S York St Ste 2000",
            "city": "Elmhurst",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601265634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

Verify at the official NPI Registry.