Active NPI
Brenda M Kenduck
- Adult Companion
- Dunnellon, FL
National Provider Identifier
1295039212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- Practice address
- 7860 SW 204TH Ave
Dunnellon, FL 34431-5169 - Phone
- (352) 362-8074
- Fax
- (352) 465-3243
- NPI assigned
- Jan 5, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion | 372600000X | Primary |
Addresses
Primary practice location
7860 SW 204TH Ave
Dunnellon, FL 34431-5169
Mailing address
7860 SW 204TH Ave
Dunnellon, FL 34431-5169
Phone (352) 362-8074
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 679111596 | Medicaid | FL |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kenduck Izquierdo Support Services, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Developmentally Disabled Services Day Training Agency
- Dunnellon, FL
- NPI 1790089712
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294185600000",
"number": "1295039212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7860 SW 204TH AVE",
"city": "DUNNELLON",
"state": "FL",
"postal_code": "344315169",
"telephone_number": "352-362-8074",
"fax_number": "352-465-3243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7860 SW 204TH AVE",
"city": "DUNNELLON",
"state": "FL",
"postal_code": "344315169",
"telephone_number": "352-362-8074",
"fax_number": "352-465-3243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENDUCK",
"first_name": "BRENDA",
"middle_name": "M",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-05",
"last_updated": "2011-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "679111596",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dunnellon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.