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

Kenneth A Waterson, PA

Individual provider Physician Assistant · NPI 1316255417

Kenneth A Waterson, PA is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2010, 16 years ago. Practices with Orthopaedic Associates of Grand Rapids PC, a 86-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
16
Licensed in
MI
In the registry since
2010
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Phone: (616) 459-7101
Fax: (616) 464-6170
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 5601005898 (MI)
Physician Assistant Taxonomy 363A00000X · Licence 5601005898 (MI)

Record details

NPI number1316255417
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 23, 2010
Last updated in NPPESDecember 30, 2013

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Orthopaedic Associates Of Grand Rapids Pc — 86 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Grand Rapids