Kenneth a Borenitsch D O P C

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

5101007441 Issued in MI

Legal business name

KENNETH A BORENITSCH D O P C

Practice address

1237 E Parkdale Ave
Suite 2
Manistee, MI 49660-9353

Phone

(231) 723-8521

Fax

(231) 398-0478

NPI assigned

Feb 28, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Albert Borenitsch, D.O.

Title

President

Phone

(231) 723-8521

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1330387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393459200000",
    "number": "1407120165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 E PARKDALE AVE",
            "address_2": "SUITE 2",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609353",
            "telephone_number": "231-723-8521",
            "fax_number": "231-398-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 E PARKDALE AVE",
            "address_2": "SUITE 2",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609353",
            "telephone_number": "231-723-8521",
            "fax_number": "231-398-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH A BORENITSCH D O P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-28",
        "last_updated": "2014-02-27",
        "status": "A",
        "authorized_official_last_name": "BORENITSCH",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "ALBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-723-8521",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101007441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "015512665",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1405970",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin P Terry DDS PLLC
• Nicole Kanomata, FNP
• Charles Joseph Keil, O.D.
• Michael Keith
• Faith Yung Min Kelley, FNP-BC
• Jesse Leah Keson, FNP
• Bryan Keith Kidd, PT
• Gracie Kierczynski
• Kimberly S Anderson DC PLC
• Kristen King

• General Practice Physician in Manistee, MI
• Providers in Manistee, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.

Verify at the official NPI Registry.