Kenneth Ethan Lai, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

114891 Issued in FL

Practice address

7208 W Sand Lake Rd Ste 305
Orlando, FL 32819-5279

Phone

(407) 799-8808

Fax

(407) 440-4307

NPI assigned

Sep 12, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Psychiatry

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Resource Managment of Wiregrass, LLCGroup PAC ID 5698714525, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alabamaclinics.kennethlai@157820.advancedmd-direct.com
• Direct secure messaging: kenneth.lai@hca4.eclinicaldirectplus.com

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.

• Professional Resource Managment of Wiregrass, LLC

  • Psychiatry Physician
  • Ozark, AL
  • NPI 1740358837

  Single Specialty

  Medicare reassignment Care Compare group NPD
• La Amistad Residential Treatment Center LLC

  • Psychiatric Hospital
  • Orlando, FL
  • NPI 1235252602

  Single Specialty

  Medicare reassignment NPD
• MCCD FL Psychiatry Services PA

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1659003457

  Single Specialty

  Medicare reassignment NPD
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606

  Single Specialty

  Medicare reassignment NPD
• Clearmindforall, Inc

  • Psychiatry Physician
  • Clearwater, FL
  • NPI 1437970381

  Single Specialty

  NPD Authorized official
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1285783134

  Single Specialty

  NPD
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349

  Single Specialty

  NPD
• Meghani Medical, PC

  • Psychiatry Physician
  • Dothan, AL
  • NPI 1942235460

  Single Specialty

  NPD
• Professional Resource Management of Wiregrass, LLC

  • Psychiatry Physician
  • Dothan, AL
  • NPI 1033495221

  Single Specialty

  NPD
• Professional Resource Management of Wiregrass, LLC

  • Neurology Physician
  • Dothan, AL
  • NPI 1801163506

  Single Specialty

  NPD
• Prestige Medical LLC

  • Psychiatry Physician
  • Mobile, AL
  • NPI 1629452123

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1376893974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6968 PHILLIPS RESERVE CT FL 7208W",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197809",
            "telephone_number": "407-558-0188",
            "fax_number": "407-440-4307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7208 W SAND LAKE RD STE 305",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195279",
            "telephone_number": "407-799-8808",
            "fax_number": "407-440-4307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 SW Holden St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981263505",
            "country_code": "US",
            "telephone_number": "206-933-7299",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "47 Long Lots Rd",
            "address_purpose": "LOCATION",
            "city": "Westport",
            "state": "CT",
            "postal_code": "068803828",
            "country_code": "US",
            "telephone_number": "203-227-1251",
            "fax_number": "203-226-8616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAI",
        "first_name": "KENNETH",
        "middle_name": "ETHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-12",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "114891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "1184190753",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1184190753",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grecia Lagunas
• Federico Ricardo Laham, M.D.
• Luis E Lahens-Hernandez, RBT
• Teanna Lahens
• Heng Chai Lai, ARNP
• Kimberly Lai
• Azmeena Laila, MD
• Laine Management Group ,LLC
• Lara Lainez
• Brandilyn Laishley

• Psychiatry Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.