NPIMap

Organization Active NPI

Kenneth Ross DO LLC

  • Family Medicine Physician
  • House Springs, MO
National Provider Identifier
1295038354
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R9C07 Issued in MO
Legal business name
KENNETH ROSS DO LLC
Practice address
4 Ponder Executive PLZ
House Springs, MO 63051-3431
Phone
(636) 671-1563
Fax
(636) 671-3364
NPI assigned
Dec 13, 2010
Last updated
Jan 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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

Authorized official

Name
Dr. Kenneth Earl Ross, DONPI 1033286596
Title
Owner
Phone
(636) 671-1563

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X R9C07 MO Primary

Addresses

Primary practice location

4 Ponder Executive PLZ
House Springs, MO 63051-3431

Mailing address

4 Ponder Executive PLZ
House Springs, MO 63051-3431
Phone (636) 671-1563

Other names 1

  • DR KENNETH E ROSS DO LLC Other name

National Provider Directory

National Provider Directory

Locations

4 Ponder Executive Plz
House Springs, MO 63051
Phone (636) 671-1563

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294272000000",
    "number": "1295038354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PONDER EXECUTIVE PLZ",
            "city": "HOUSE SPRINGS",
            "state": "MO",
            "postal_code": "630513431",
            "telephone_number": "636-671-1563",
            "fax_number": "636-671-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PONDER EXECUTIVE PLZ",
            "city": "HOUSE SPRINGS",
            "state": "MO",
            "postal_code": "630513431",
            "telephone_number": "636-671-1563",
            "fax_number": "636-671-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH ROSS DO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-13",
        "last_updated": "2011-01-06",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-671-1563",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R9C07",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DR KENNETH E ROSS DO LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in House Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; 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.