Active NPI
Kendrek Allen Hayden
- Driver
- Milwaukee, WI
National Provider Identifier
1316609233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- H3505017912708
- Practice address
- 4215 N Stowell Ave
Milwaukee, WI 53211-1746 - Phone
- (414) 554-7570
- NPI assigned
- Oct 7, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Driver | 172A00000X | H3505017912708 | WI | Primary |
Addresses
Primary practice location
4215 N Stowell Ave
Milwaukee, WI 53211-1746
Mailing address
4215 N Stowell Ave
Milwaukee, WI 53211-1746
Phone (414) 554-7570
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H3505017912708 | WI | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633564800000",
"number": "1316609233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4215 N STOWELL AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532111746",
"telephone_number": "414-554-7570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4215 N STOWELL AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532111746",
"telephone_number": "414-554-7570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYDEN",
"first_name": "KENDREK",
"middle_name": "ALLEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-07",
"last_updated": "2021-10-07",
"certification_date": "2021-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "WI",
"license": "H3505017912708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.