Kenneth Gerald Keener, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302021895 Issued in MI

Practice address

5625 Water Tower PL
Suite 101
Clarkston, MI 48346-2671

Phone

(248) 625-1215

Fax

(248) 620-4258

NPI assigned

Oct 4, 2006

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

Credentials

Registered Pharmacist

State licenses

Practice roles

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.

• Pine Knob Pharmacy #2

  • Durable Medical Equipment & Medical Supplies
  • Clarkston, MI
  • NPI 1548438724
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326133174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5625 WATER TOWER PL",
            "address_2": "SUITE 101",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462671",
            "telephone_number": "248-625-1215",
            "fax_number": "248-620-4258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 WATER TOWER PL",
            "address_2": "SUITE 101",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462671",
            "telephone_number": "248-625-1215",
            "fax_number": "248-620-4258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENER",
        "first_name": "KENNETH",
        "middle_name": "GERALD",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302021895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roodi Ghassan-Tobya Katoola
• Kaelyn Kaul
• Vineet Kaul
• Rebecca Jean Keagy, O.D.
• Peter William Keelin, PH.D.
• Julie Kehren, SLP
• Eve Kehrer
• Kehres Health and Chiropractic
• Veronica Kelty, RN
• Brittany Kenerson

• Pharmacist in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.