Kenley Emergency Medicine Corporation

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

A100640 Issued in CA

Legal business name

KENLEY EMERGENCY MEDICINE CORPORATION

Doing business as

MEDICUS VIP

Practice address

100 N Wiget LN Ste 200
Walnut Creek, CA 94598-5901

Phone

(773) 632-7244

NPI assigned

Aug 18, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Eric S Kenley, MD

Title

Owner

Phone

(773) 632-7244

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MEDICUS VIP Doing business as

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1396261582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N WIGET LN STE 200",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945985901",
            "telephone_number": "773-632-7244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N WIGET LN STE 200",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945985901",
            "telephone_number": "773-632-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENLEY EMERGENCY MEDICINE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KENLEY",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-632-7244",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "A100640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194847475",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICUS VIP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexis Kellog
• Devlin Kelly, PH.D.
• Marisa Anne Kelly
• Marianne Collins Kemp
• Alice Tam Kengla, M.D.
• Jessica Kennady
• Jalynn Kennedy
• Kennewick Radiology Group, PC
• Emily Marie Kent
• Kristine Kent, CMT

• Multi-Specialty Clinic/Center in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.