Kenneth Charles Agnew Jr., CRNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

SP025288 Issued in PA

Practice address

5037 Crystal Dr
Erie, PA 16505-2913

Phone

(814) 218-1850

NPI assigned

Mar 29, 2022

Last updated

Mar 29, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Ahn Emergency Group of Canonsburg LTD.

  • Emergency Medicine Physician
  • Canonsburg, PA
  • NPI 1790100154
  Medicare reassignment NPD
• Ahn Emergency Group of Erie County LTD.

  • Emergency Medicine Physician
  • Erie, PA
  • NPI 1336564798
  Medicare reassignment NPD
• Ahn Emergency Group of Jefferson LTD

  • Emergency Medicine Physician
  • Jefferson Hills, PA
  • NPI 1235518499
  Medicare reassignment NPD
• Ahn Observation Group LLC

  • Emergency Medicine Physician
  • Jefferson Hills, PA
  • NPI 1437814696
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  PA

  Medicare reassignment NPD

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1013657295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5037 CRYSTAL DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052913",
            "telephone_number": "814-218-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5037 CRYSTAL DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052913",
            "telephone_number": "814-218-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGNEW",
        "first_name": "KENNETH",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP025288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manushi Aggarwal, MD
• Priyanka Aggarwal, M.D.
• Agilesol Health LLC
• Christine M Agnello, LPC
• Christine Marie Agnello, M.D.
• Tracy L Agnew, CRNP
• Dennis E Agostini, DO
• Robert William Agostino, DC
• Helen Anne Agresti, R.D.
• Jacob M Agris, MD

• Primary Care Nurse Practitioner in Erie, PA
• Providers in Erie, PA by specialty
• Primary Care Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.