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

Kenneth F Shockley, DO

Individual provider Urology Physician · NPI 1801854039

Kenneth F Shockley, DO is an Urology in Grand Rapids, Michigan. Graduated from Philadelphia College of Osteopathic Medicine in 1989, 37 years ago. Practices with Michigan Institute of Urology PC, a 83-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
37
Trained at
Philadelphia College of Osteopathic Medicine
Licensed in
MI
In the registry since
2006
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

4047 E Hills Ct SE
Grand Rapids, MI 49546-6249
Phone: (616) 956-9577
Fax: (616) 956-5988
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 5101010606 (MI)

Record details

NPI number1801854039
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedMay 4, 2006
Last updated in NPPESFebruary 18, 2026
Certification dateFebruary 18, 2026
Mailing address20952 E 12 Mile Rd Ste 200, Saint Clair Shores, MI 48081-3203

Medicare enrollment

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

Medicare specialtyUROLOGY
Medical schoolPHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 1989 (37 years in practice)
Group practice Michigan Institute Of Urology Pc — 83 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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