KC Medical Concept, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

KC MEDICAL CONCEPT, LLC

Practice address

102B Route 112
Port Jefferson Station, NY 11776-1018

Phone

(631) 509-4774

NPI assigned

Jan 20, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Karen Mourtzikos, M.D

Title

Director

Phone

(631) 509-4774

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366675200000",
    "number": "1407127525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102B ROUTE 112",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761018",
            "telephone_number": "631-509-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102B ROUTE 112",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761018",
            "telephone_number": "631-509-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KC MEDICAL CONCEPT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-20",
        "last_updated": "2013-04-23",
        "status": "A",
        "authorized_official_last_name": "MOURTZIKOS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-509-4774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin P Kaplan, MD
• Bianca Karwowski, MA, CCC-SLP
• Karyn M. Halpern, D.M.D., P.C.
• Darren Scott Kaufman, M.D.
• Raj Devpriti Kaur, RN
• Kevin Keary, RPH
• Adrianne Kelly, MS, OTR/L
• Kenneth a. Schreiber, MD,PC
• Kenneth G Rosenthal M.D.PC
• Warren L Kent, DPM

• Clinic/Center in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.