Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Justin Michael Kennedy, PA-C

Individual provider Medical Physician Assistant · NPI 1528415767

Justin Michael Kennedy, PA-C is a Medical Physician Assistant in Grapevine, Texas. Licensed in Texas. Registered with an NPI since 2016.

Licensed in
TX
In the registry since
2016
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2020 W St Hwy 114 Ste 120
Grapevine, TX 76051-8649
Phone: (817) 912-8300
Fax: (817) 912-8310
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence P9256 (TX)
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1528415767
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 18, 2016
Last updated in NPPESDecember 4, 2025
Certification dateDecember 4, 2025

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