Kokomo Surgical Group, LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

KOKOMO SURGICAL GROUP, LLC

Practice address

2000 W Boulevard
Kokomo, IN 46902-6079

Phone

(765) 456-1790

Fax

(765) 457-3561

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Annemarie P Desanto, M.D.

Title

Partner

Phone

(765) 456-1790

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255996800000",
    "number": "1437286655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026079",
            "telephone_number": "765-456-1790",
            "fax_number": "765-457-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026079",
            "telephone_number": "765-456-1790",
            "fax_number": "765-457-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOKOMO SURGICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2009-10-20",
        "status": "A",
        "authorized_official_last_name": "DESANTO",
        "authorized_official_first_name": "ANNEMARIE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "765-456-1790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100420490",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kokomo Pediatric Dentistry, LLC
• Kokomo Place Assisted Living LLC
• Kokomo RCF LP
• Kokomo School Corporation
• Kokomo Sleep Center, LLC
• Kokomo Urology Inc.
• Brooke Komar
• Steven Louis Konechnik, DPT
• Jennifer L Korreckt, BCBA
• Aaron Kosberg, DPT

• Surgery Physician in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; 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.