Individual provider Active NPI

Kenneth H Z Isaacs, MD

  • Neurology Physician
  • Walla Walla, WA
National Provider Identifier
1023072006
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
19635 Issued in WA
Practice address
301 W Poplar St
Suite 230
Walla Walla, WA 99362-2800
Phone
(509) 525-1084
Fax
(509) 529-7866
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 19635 WA Primary

Addresses

Primary practice location

301 W Poplar St
Suite 230
Walla Walla, WA 99362-2800

Mailing address

301 W Poplar St
Suite 230
Walla Walla, WA 99362-2800
Phone (509) 525-1084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19635WAMDNeurology Physician
14614ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1023072006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W POPLAR ST",
            "address_2": "SUITE 230",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622800",
            "telephone_number": "509-525-1084",
            "fax_number": "509-529-7866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W POPLAR ST",
            "address_2": "SUITE 230",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622800",
            "telephone_number": "509-525-1084",
            "fax_number": "509-529-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAACS",
        "first_name": "KENNETH",
        "middle_name": "H Z",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "19635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.