Organization Active NPI

Kenneth H. Tozer II, MD

  • Specialist
  • Milan, TN
National Provider Identifier
1053413237
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD016387 Issued in TN
Legal business name
KENNETH H. TOZER II, MD
Practice address
4022 Liberty St
Milan, TN 38358-3453
Phone
(731) 686-7004
Fax
(731) 686-7078
NPI assigned
Sep 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kenneth Harold Tozer II, M.D.NPI 1366489270
Title
Surgeon
Phone
(731) 686-7004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD016387 TN Primary

Addresses

Primary practice location

4022 Liberty St
Milan, TN 38358-3453

Mailing address

4022 Liberty St
Milan, TN 38358-3453
Phone (731) 686-7004

Other identifiers 4

IdentifierTypeStateIssuer
03013966MedicaidTN
03734638MedicaidTN
0046019OtherTNBCBS
3013964MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060913000070 TN Part B Supplier - Clinic/Group Practice 7416951058 Receives reassigned benefits from 3 practitioners
Practice locations: Milan, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053413237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4022 LIBERTY ST",
            "city": "MILAN",
            "state": "TN",
            "postal_code": "383583453",
            "telephone_number": "731-686-7004",
            "fax_number": "731-686-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4022 LIBERTY ST",
            "city": "MILAN",
            "state": "TN",
            "postal_code": "383583453",
            "telephone_number": "731-686-7004",
            "fax_number": "731-686-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH H. TOZER II, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TOZER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "HAROLD",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "731-686-7004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD016387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03013966",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03734638",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0046019",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3013964",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milan, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.