Kenneth Bruce Quenneville, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2009029477 Issued in MO

Practice address

12000 County Road 801
Memphis, MO 63555-2024

Phone

(660) 988-1296

NPI assigned

Mar 10, 2006

Last updated

Oct 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863
  NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487
  NPD
• Golden Valley Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Clinton, MO
  • NPI 1306814306
  NPD (past)
• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  NPD (past)
• Brazos Emergency Physicians, PA

  • Emergency Medicine Physician
  • Houston, TX
  • NPI 1205948635
  NPD (past)
• Odessa Physician Associates, PLLC

  • Emergency Medicine Physician
  • Odessa, TX
  • NPI 1457398364
  NPD (past)

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1174591556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12000 COUNTY ROAD 801",
            "city": "MEMPHIS",
            "state": "MO",
            "postal_code": "635552024",
            "telephone_number": "660-988-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 COUNTY ROAD 801",
            "city": "MEMPHIS",
            "state": "MO",
            "postal_code": "635552024",
            "telephone_number": "660-988-1296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUENNEVILLE",
        "first_name": "KENNETH",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "39876",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2009029477",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "2009029477",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northeast Missouri Health Council, Inc. (Northeast Missouri Family Health Clinic)
• Susanne Renee Owens, CRNA
• Kylee Nichole Perkins, PTA
• Lisa Marie Peterson, LCSW
• Pkanesthesia, Inc
• Lois Quenneville, P.A.
• Nicholas R Rhodes, L.M.T
• Scotland Co. R-1
• Scotland County Ambulance District
• Scotland County Community Health Development Services, Inc. (Memphis Community Pharmacy)

• Emergency Medicine Physician in Memphis, MO
• Providers in Memphis, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.