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

Individual provider Physician Assistant · NPI 1164056727

Michael James Church, PA-C is a Physician Assistant in Kenosha, Wisconsin. Qualified in 2020, 6 years ago. Practices with Vituity-Wisconsin Hm SC, a 29-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
6
Licensed in
WI
In the registry since
2020
Specialties on file
3
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

6308 8th Ave
Kenosha, WI 53143-5031
Phone: (262) 656-2011
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 636 Manhattan Rd Se, Grand Rapids, MI 49506-2025 — (616) 295-5062

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5119-23 (WI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Medical Physician Assistant Taxonomy 363AM0700X · Licence 5119-23 (WI)

Record details

NPI number1164056727
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 23, 2020
Last updated in NPPESSeptember 2, 2020
Certification dateSeptember 2, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Vituity-Wisconsin Hm Sc — 29 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Kenosha