NPIMap

Individual provider Active NPI

Kenneth A Griffith II, PAC

  • Physician Assistant
  • Centreville, MI
National Provider Identifier
1972980720
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007364 Issued in MI
Practice address
677 E Main St
Centreville, MI 49032-8524
Phone
(269) 467-1000
NPI assigned
Apr 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 5601007364 MI Primary

Addresses

Primary practice location

677 E Main St
Centreville, MI 49032-8524

Mailing address

677 E Main St
Centreville, MI 49032-8524
Phone (269) 467-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150609001876 MI Practitioner - Physician Assistant 5193046662 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601007364MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital Physician Assistant CurrentSince Jan 20, 2019 Accepting new patients
Bronson Methodist Hospital Physician Assistant CurrentSince Nov 1, 2017 Accepting new patients
Hometown Urgent Care of Michigan, PC CurrentSince Jun 27, 2022 Accepting new patients
Hometown Urgent Care of Michigan, P.C. CurrentSince Jun 27, 2022 Accepting new patients
Bronson South Haven Hospital CurrentSince Jan 20, 2019 Accepting new patients
Hometown Urgent Care of Michigan, P.C. Current Accepting new patients
Bronson South Haven Hospital CurrentSince Jan 20, 2019 Accepting new patients
Lansing Urgent Care, PLC Past Accepting new patients

Locations

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835

6220 W Main St
Kalamazoo, MI 49009
Phone (269) 276-4744

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

950 S Bailey Ave
South Haven, MI 49090
Phone (269) 639-2796

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1972980720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 E MAIN ST",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "490328524",
            "telephone_number": "269-467-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 E MAIN ST",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "490328524",
            "telephone_number": "269-467-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFITH",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_suffix": "II",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-30",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Centreville, MI

Sources for this page

Verify at the official NPI Registry.