Individual provider Active NPI

Larry Alan Kean, M.D.

  • Psychiatry Physician
  • Martinez, CA
National Provider Identifier
1154318830
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
200500068 Issued in NC
Practice address
2500 Alhambra Ave
Martinez, CA 94553-3156
Phone
(704) 671-5344
Fax
(704) 671-5331
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 200500068 NC Primary

Addresses

Primary practice location

2500 Alhambra Ave
Martinez, CA 94553-3156

Mailing address

2240 Remount Rd
Gastonia, NC 28054-4725
Phone (704) 671-5311

Other identifiers 1

IdentifierTypeStateIssuer
5900427MedicaidNC

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

LicenseStateTypeSpecialty
200500068NCMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1154318830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 REMOUNT RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544725",
            "telephone_number": "704-671-5311",
            "fax_number": "704-671-5308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ALHAMBRA AVE",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945533156",
            "telephone_number": "704-671-5344",
            "fax_number": "704-671-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEAN",
        "first_name": "LARRY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "200500068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900427",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; 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.