Organization Active NPI

Kenneth Appah Sampong, P.a.

  • Cardiovascular Disease Physician
  • Leesburg, FL
National Provider Identifier
1073674404
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
KENNETH APPAH SAMPONG, P.A.
Practice address
709 Physicians CT
Leesburg, FL 34748-7357
Phone
(352) 728-5116
Fax
(352) 728-5928
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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

Authorized official

Name
Dr. Kenneth Appah Sampong, M.D.NPI 1649236167
Title
President
Phone
(352) 728-5116

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

709 Physicians CT
Leesburg, FL 34748-7357

Mailing address

709 Physicians CT
Leesburg, FL 34748-7357
Phone (352) 728-5116

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051206000248 FL Part B Supplier - Clinic/Group Practice 4486674454 Receives reassigned benefits from 1 practitioner
Practice locations: Leesburg, FL; Oxford, FL; Summerfield, FL; The Villages, FL; Wildwood, FL

National Provider Directory

National Provider Directory

Locations

4056 E State Road 44
Wildwood, FL 34785
Phone (321) 248-2666

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361145600000",
    "number": "1073674404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 PHYSICIANS CT",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487357",
            "telephone_number": "352-728-5116",
            "fax_number": "352-728-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 PHYSICIANS CT",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487357",
            "telephone_number": "352-728-5116",
            "fax_number": "352-728-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH APPAH SAMPONG, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2013-02-18",
        "status": "A",
        "authorized_official_last_name": "SAMPONG",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "APPAH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-728-5116",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; 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.