Active NPI
Kenneth A Turk, MD
- Pediatrics Physician
- Perrysburg, OH
National Provider Identifier
1366434375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 35078516
- Practice address
- 1620 Brigham Dr Ste 240
Perrysburg, OH 43551-7124 - Phone
- (419) 872-7700
- Fax
- (419) 874-0196
- NPI assigned
- Aug 16, 2005
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35078516 | OH | Primary |
Addresses
Primary practice location
1620 Brigham Dr Ste 240
Perrysburg, OH 43551-7124
Mailing address
333 N Summit St FL 7
Toledo, OH 43604-1531
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03792 | Other | OH | PHC |
| 12-88038 | Other | OH | UHC |
| 2428937 | Other | OH | AETNA |
| 2188672 | Medicaid | OH | |
| 000000141212 | Other | OH | ANTHEM |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kturk13443@epicdirect.promedica.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130730001001 | OH | Order and Referring Only - Pediatric Medicine | 8527209782 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35078516 | OH | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Promedica Central Physicians | 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.
-
- Family Medicine Physician
- Toledo, OH
- NPI 1043270150
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1366434375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 N SUMMIT ST FL 7",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436041531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 BRIGHAM DR STE 240",
"city": "PERRYSBURG",
"state": "OH",
"postal_code": "435517124",
"telephone_number": "419-872-7700",
"fax_number": "419-874-0196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TURK",
"first_name": "KENNETH",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-16",
"last_updated": "2023-11-03",
"certification_date": "2023-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "35078516",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHC",
"identifier": "03792",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "12-88038",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2428937",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2188672",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000141212",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kturk13443@epicdirect.promedica.org",
"affiliation": "N",
"address_1": "100 Madison Ave",
"city": "Toledo",
"state": "OH",
"country_code": "US",
"postal_code": "436041516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Perrysburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.