Individual provider Active NPI

Kenneth Glenn Lain, PHD

  • Durable Medical Equipment & Medical Supplies
  • Abilene, TX
National Provider Identifier
1255874145
Registry record updated Nov 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
1001274 Issued in TX
Practice address
4351 Ridgemont Dr Ste C
Abilene, TX 79606-8747
Phone
(325) 668-7591
Fax
(325) 698-4547
NPI assigned
Nov 23, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 1001274 TX Primary

Addresses

Primary practice location

4351 Ridgemont Dr Ste C
Abilene, TX 79606-8747

Mailing address

4351 Ridgemont Dr Ste C
Abilene, TX 79606-8747
Phone (325) 668-7591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1001274TXMDDurable Medical Equipment & Medical Supplies

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Health Services Inc. Past Accepting new patients
Professional Health Services Inc Durable Medical Equipment & Medical Supplies Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480032000000",
    "number": "1255874145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4351 RIDGEMONT DR STE C",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796068747",
            "telephone_number": "325-668-7591",
            "fax_number": "325-698-4547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4351 RIDGEMONT DR STE C",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796068747",
            "telephone_number": "325-668-7591",
            "fax_number": "325-698-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIN",
        "first_name": "KENNETH",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-23",
        "last_updated": "2016-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "1001274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.