Kendall P. Tabor, DPM, FACFS

Primary specialty

PodiatristTaxonomy code 213E00000X

License

5901001089 Issued in MI

Practice address

1414 W Fair Ave
Ste 215
Marquette, MI 49855-2675

Phone

(906) 225-7709

Fax

(906) 225-7707

NPI assigned

Jun 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Southwest Footcare Specialists, P.C.

  • Foot & Ankle Surgery Podiatrist
  • Portage, MI
  • NPI 1457596793
  NPD (past)

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1184620908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 HOWARD ST",
            "address_2": "STE 215",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081917",
            "telephone_number": "269-385-1000",
            "fax_number": "269-385-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "STE 215",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-7709",
            "fax_number": "906-225-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABOR",
        "first_name": "KENDALL",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "DPM, FACFS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001089",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901001089",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1053597914",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2126020",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Margaret Swenor, NURSE PRACTITINER
• Andrew G Swentik, MD
• Synergy Fitness, LLC (Synergy Fitness)
• Emilee Syrjala, NP-C
• Kortni Susan Szukalowski
• Sharon L Tabor, CPED/CFO
• Tony M Tanious
• Chauntelle Leigh Taylor, FNP-BC
• Galina S Taylor, LMSW, CAADC, QMHP
• Nathan Samuel Taylor, MD

• Podiatrist in Marquette, MI
• Providers in Marquette, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; 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.