Kenneth Homer, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME 47305 Issued in FL

Practice address

5601 N Dixie Hwy
Suite 412
Oakland Park, FL 33334-4148

Phone

(954) 491-2140

Fax

(954) 491-9640

NPI assigned

Jul 27, 2006

Last updated

Mar 11, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Holy Cross Hospital Inc

  dba Holy Cross Medical Group

  • Internal Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1467401877
  Medicare reassignment NPD
• Holy Cross Hospital, Inc

  dba Holy Cross Diabetes Prevention Program

  • Health & Wellness Coach
  • Oakland Park, FL
  • NPI 1063207595
  NPD

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268265600000",
    "number": "1205840428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 N DIXIE HWY",
            "address_2": "SUITE 412",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333344148",
            "telephone_number": "954-491-2140",
            "fax_number": "954-491-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 N DIXIE HWY",
            "address_2": "SUITE 412",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333344148",
            "telephone_number": "954-491-2140",
            "fax_number": "954-491-9640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMER",
        "first_name": "KENNETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2010-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 47305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holy Cross Hospital, Inc (Holy Cross Diabetes Prevention Program)
• Home for Golden Age LLC
• Home Health Smiles North LLC
• Home Sweet Home of Oakland Park
• Homecare America of South Florida, Inc. (Mobility City)
• Hope & Grace Recovery Center, LLC
• Hope and Grace Rehabilitation, LLC
• Humanity & Blessings Home Health Care Corp.
• Hummingbird Home Services LLC (Hummingbird Commercial Cleaning)
• Taylor Hurd, DPT

• Internal Medicine Physician in Oakland Park, FL
• Providers in Oakland Park, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; 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.