Kenneth James Vining, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10003680 Issued in WA

Practice address

Naval Hospital Bremerton
1 Boone Road
Bremerton, WA 98312-1898

Phone

(360) 315-4346

Fax

(360) 396-4247

NPI assigned

Oct 31, 2005

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1023009008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL HOSPITAL BREMERTON",
            "address_2": "1 BOONE ROAD",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983121898",
            "telephone_number": "360-315-4346",
            "fax_number": "360-396-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL HOSPITAL BREMERTON",
            "address_2": "1 BOONE ROAD",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983121898",
            "telephone_number": "360-315-4346",
            "fax_number": "360-396-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINING",
        "first_name": "KENNETH",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10003680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Villanueva
• Lori Vincent
• Jaclyn Vinecourt
• Morgan Marie Vines
• Christina Viniarski, PSYD
• Susan Gwendolyn Visco
• Alec Rocim Voecks
• Mikal Vogt
• Edward G Vonberg, PHARM.D.
• Misty Rose Voshall, LMP

• Medical Physician Assistant in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.