Kenai Peninsula Urology, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

2316 Issued in AK

Legal business name

KENAI PENINSULA UROLOGY, LLC

Practice address

262 N Binkley St
Soldotna, AK 99669-7522

Phone

(907) 262-5788

Fax

(907) 262-6099

NPI assigned

May 14, 2007

Last updated

Dec 20, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gary John Schoenrock, M.D

Title

Managing Member

Phone

(907) 262-5788

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324339200000",
    "number": "1033324892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 N BINKLEY ST",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697522",
            "telephone_number": "907-262-5788",
            "fax_number": "907-262-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 N BINKLEY ST",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697522",
            "telephone_number": "907-262-5788",
            "fax_number": "907-262-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENAI PENINSULA UROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2011-12-20",
        "status": "A",
        "authorized_official_last_name": "SCHOENROCK",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "907-262-5788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AK",
            "license": "2316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD23162",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenai Peninsula Health System LLC Urgent Care of Soldotna
• Kenai Peninsula Home Health LLC
• Kenai Peninsula Hospice LLC
• Kenai Peninsula Massage Therapy Inc.
• Kenai Peninsula Mental Health LLC
• Kenai River Counseling
• Kenaitze Indian Tribe (Dena'ina Wellness Center Soldotna)
• Marissa Kennedy
• Kenneth G Youngberg PC
• Kenneth Owens (brothers and sons)

• Specialist in Soldotna, AK
• Providers in Soldotna, AK by specialty
• Specialist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; 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.