Kenneth Blake, H.I.S.

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

HA7407 Issued in CA

Practice address

39000 Bob Hope Drive Probst 315
Rancho Mirage, CA 92270-3221

Phone

(760) 625-6616

Fax

(442) 666-3766

NPI assigned

Jul 15, 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Bighorn Hearing Aid Center, Inc

  • Hearing Instrument Specialist
  • Rancho Mirage, CA
  • NPI 1548548795
  Authorized official Same address or phone

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1013933589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DRIVE PROBST 315",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-625-6616",
            "fax_number": "442-666-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DRIVE PROBST 315",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-625-6616",
            "fax_number": "442-666-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "KENNETH",
        "credential": "H.I.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC172371",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC17237",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "HA7407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE COMPANIES",
            "identifier": "DC172371",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bishoy Labib M.D. Inc
• Paul Alexander Biskar, M.D.
• James Bivins, NURSE PRACTITIONER
• Leland Paul Black, MD
• Lawrence Burnett Blackmon, D.D.S.
• Burton Charles Blaurock, O.D.
• BLC Mirage Inn, L.P. (Brookdale Mirage Inn)
• Beverly Belle Blessing, FNP, PHD
• Jonathan William Blevins, M.D.
• Block Counseling, Family & Child Therapy Inc.

• Hearing Instrument Specialist in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Hearing Instrument Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.