Individual provider Active NPI

Kenneth B Tennyson, M.D.

  • Diagnostic Radiology Physician
  • Houston, TX
National Provider Identifier
1396736286
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D8099 Issued in TX
Practice address
12951 South Fwy
Houston, TX 77047-1923
Phone
(713) 526-5771
Fax
(713) 526-2036
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X D8099 TX Primary

Addresses

Primary practice location

12951 South Fwy
Houston, TX 77047-1923

Mailing address

PO Box 4346
Dept 251
Houston, TX 77210-4346
Phone (713) 331-1850

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D8099TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Houston Spring Branch Radiology Assoc., LLP Diagnostic Radiology Past Accepting new patients
Baylor College of Medicine Dept of Radiology Diagnostic Radiology Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1396736286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4346",
            "address_2": "DEPT 251",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104346",
            "telephone_number": "713-331-1850",
            "fax_number": "713-521-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12951 SOUTH FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770471923",
            "telephone_number": "713-526-5771",
            "fax_number": "713-526-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNYSON",
        "first_name": "KENNETH",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "D8099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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.