Kenneth R Hart, D.O.

Primary specialty

Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X

License

F8504 Issued in TX

Practice address

5101 Medical Drive
San Antonio, TX 78229-4801

Phone

(210) 592-5349

Fax

(210) 592-5462

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kenneth R Hart DO PA

  • Specialist
  • San Antonio, TX
  • NPI 1740327642
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1003998071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2935 THOUSAND OAKS",
            "address_2": "SUITE 294",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782473312",
            "telephone_number": "210-494-1100",
            "fax_number": "210-494-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 MEDICAL DRIVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294801",
            "telephone_number": "210-592-5349",
            "fax_number": "210-592-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "KENNETH",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "F8504",
            "primary": false
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "TX",
            "license": "F8504",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "TX",
            "license": "F8504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081285101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081285102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132637302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Travis Hart, CRNA
• Darius Blake Hart
• Denise Hart, M.D.
• Holly J Hart, P.T., D.P.T.
• Jeffrey Dale Hart, D.P.T.
• Margaret R Hart, MS CCP SLP
• Mary K Hart, RRT
• Rebecca Hart
• Robert Hart, MD
• Ashley Sharise Hartfield-Clay

• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.