Michael D Kenner, MD,PC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

MICHAEL D KENNER, MD,PC

Practice address

1721 S 10TH Ave
Caldwell, ID 83605-4839

Phone

(208) 453-1062

Fax

(208) 453-1196

NPI assigned

Jul 23, 2007

Last updated

Jul 23, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael David Kenner, MD

Title

Doctor/Owner

Phone

(208) 453-1062

Specialties & licenses 1

Addresses

Other names 1

• none Other name

Locations

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185148800000",
    "number": "1184824617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 S 10TH AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054839",
            "telephone_number": "208-453-1062",
            "fax_number": "208-453-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 S 10TH AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054839",
            "telephone_number": "208-453-1062",
            "fax_number": "208-453-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D KENNER, MD,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A",
        "authorized_official_last_name": "KENNER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "208-453-1062",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "none",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Genesis Sarai Melara, LPC
• Annamaria Melton, D.O.
• Alexandra Mendez, LMSW
• Devina Nadine Mendoza
• Micah S Mills OD PA (Treasure Valley Eyecare)
• Jacob Michelsen, PA
• Robert W Mickelson
• Andrea Mikkelson, LPC
• Casey Jay Milburn
• Margaux Elena Miller

• Cardiovascular Disease Physician in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Cardiovascular Disease Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.