Active NPI
Kenneth W Turley, MD
- Ophthalmology Physician
- Idaho Falls, ID
National Provider Identifier
1063589034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- M-4215
- Practice address
- 2025 E 17TH St
Idaho Falls, ID 83404 - Phone
- (208) 524-2025
- Fax
- (208) 529-1924
- NPI assigned
- Nov 28, 2006
- Last updated
- Jan 19, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | M-4215 | ID | Primary |
Addresses
Primary practice location
2025 E 17TH St
Idaho Falls, ID 83404
Mailing address
2025 E 17TH St
Idaho Falls, ID 83404
Phone (208) 524-2025
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002564800 | Medicaid | ID |
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
| License | State | Type | Specialty |
|---|---|---|---|
| M-4215 | ID | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263859200000",
"number": "1063589034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2025 E 17TH ST",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "83404",
"telephone_number": "208-524-2025",
"fax_number": "208-529-1924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2025 E 17TH ST",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "83404",
"telephone_number": "208-524-2025",
"fax_number": "208-529-1924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TURLEY",
"first_name": "KENNETH",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2010-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "ID",
"license": "M-4215",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002564800",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.