Sung-Keun Kenneth Tak

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

434700084 Issued in CA

Practice address

17015 Walnut Grove Dr
Suite 103
Morgan Hill, CA 95037-4436

Phone

(408) 370-6360

NPI assigned

Sep 9, 2016

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Fidelity Senior Solutions, LLC

  • In Home Supportive Care Agency
  • Morgan Hill, CA
  • NPI 1487233276
  NPD Authorized official
• SKT Group LLC

  • In Home Supportive Care Agency
  • Dallas, TX
  • NPI 1366241259
  NPD

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

{
    "created_epoch": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1235686908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17015 WALNUT GROVE DR",
            "address_2": "SUITE 103",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950374436",
            "telephone_number": "408-370-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17015 WALNUT GROVE DR",
            "address_2": "SUITE 103",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950374436",
            "telephone_number": "408-370-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAK",
        "first_name": "SUNG-KEUN",
        "middle_name": "KENNETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-09",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "CA",
            "license": "434700084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariana Suarez Rodriguez
• Randall Suarez
• Bhavna Suri, MD
• Michelle Meichih Swanson, MSTCM. LAC. MS. PHD.
• Monica S Szkorla
• Telehealth365 Inc
• Krystle Teneyuque
• Steven John Terrini, PH.D.
• Jegatri R Thayaparan, DMD
• The Family-Centered Ear, Nose, Throat Group

• Home Health Aide in Morgan Hill, CA
• Providers in Morgan Hill, CA by specialty
• Home Health Aide in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.