Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Justin Stafford, PA-C

Individual provider Physician Assistant · NPI 1083168454

Justin Stafford, PA-C is a Physician Assistant in Kettering, Ohio. Qualified in 2016, 10 years ago. Practices with Kettering Network Radiologists Inc, a 75-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
10
Licensed in
OH
In the registry since
2016
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

3535 Southern Blvd
Kettering, OH 45429-1221
Phone: (937) 395-6020
Fax: (937) 522-7873
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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 50.004770RX (OH)

Record details

NPI number1083168454
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 15, 2016
Last updated in NPPESNovember 19, 2020
Certification dateNovember 19, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Kettering Network Radiologists Inc — 75 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Kettering