Active NPI
Kenneth Franklin Yates, CCP
- Contractor
- Carmichael, CA
National Provider Identifier
1356746507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 920347
- Practice address
- 4119 Tyrone Way
Carmichael, CA 95608-1656 - Phone
- (540) 597-8165
- NPI assigned
- Oct 30, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 920347 | VA | Primary |
Addresses
Primary practice location
4119 Tyrone Way
Carmichael, CA 95608-1656
Mailing address
4119 Tyrone Way
Carmichael, CA 95608-1656
Phone (540) 597-8165
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 |
|---|---|---|---|
| 920347 | VA | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414627200000",
"number": "1356746507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4119 TYRONE WAY",
"city": "CARMICHAEL",
"state": "CA",
"postal_code": "956081656",
"telephone_number": "540-597-8165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4119 TYRONE WAY",
"city": "CARMICHAEL",
"state": "CA",
"postal_code": "956081656",
"telephone_number": "540-597-8165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YATES",
"first_name": "KENNETH",
"middle_name": "FRANKLIN",
"credential": "CCP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-10-30",
"last_updated": "2014-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "VA",
"license": "920347",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carmichael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.