Organization Active NPI

Kenneth H Farrell M.D. PA

  • Otolaryngology Physician
  • Fort Lauderdale, FL
National Provider Identifier
1356687487
Registry record updated Sep 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
19241 Issued in FL
Legal business name
KENNETH H FARRELL M.D. PA
Practice address
6405 North Federal Highway
Suite 104
Fort Lauderdale, FL 33308-1414
Phone
(954) 938-1890
Fax
(954) 938-1899
NPI assigned
Dec 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2016

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

Authorized official

Name
Dr. Kenneth H Farrell, M.D.NPI 1588664304
Title
President
Phone
(954) 938-1890

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 19241 FL Primary

Addresses

Primary practice location

6405 North Federal Highway
Suite 104
Fort Lauderdale, FL 33308-1414

Mailing address

6405 North Federal Highway
Suite 104
Fort Lauderdale, FL 33308-1414
Phone (954) 938-1890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130109000638 FL Part B Supplier - Clinic/Group Practice 3274786843 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Lauderdale, FL; Ft Lauderdale, FL

National Provider Directory

National Provider Directory

Locations

6405 N Federal Hwy
Ste 104
Ft Lauderdale, FL 33308
Phone (954) 938-1890

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475107200000",
    "number": "1356687487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 NORTH FEDERAL HIGHWAY",
            "address_2": "SUITE 104",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333081414",
            "telephone_number": "954-938-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 NORTH FEDERAL HIGHWAY",
            "address_2": "SUITE 104",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333081414",
            "telephone_number": "954-938-1890",
            "fax_number": "954-938-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH H FARRELL M.D. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-18",
        "last_updated": "2016-09-29",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-938-1890",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "19241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.