Active NPI
Alexander Kenney, PA-C
- Physician Assistant
- Fort Polk, LA
National Provider Identifier
1104354968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1141986
- Practice address
- 1585 3Rd St
Fort Polk, LA 71459-5102 - Phone
- (803) 260-9993
- NPI assigned
- May 24, 2017
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1141986 | Primary |
Addresses
Primary practice location
1585 3Rd St
Fort Polk, LA 71459-5102
Mailing address
1585 3Rd St
Fort Polk, LA 71459-5102
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666051200000",
"number": "1104354968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1585 3RD ST",
"city": "FORT POLK",
"state": "LA",
"postal_code": "714595102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1585 3RD ST",
"city": "FORT POLK",
"state": "LA",
"postal_code": "714595102",
"telephone_number": "803-260-9993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEY",
"first_name": "ALEXANDER",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-24",
"last_updated": "2022-10-18",
"certification_date": "2022-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": "1141986",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Polk, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.