Active NPI
Kennon Danos
- Certified Registered Nurse Anesthetist
- Ocean Springs, MS
National Provider Identifier
1457486755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R726397
- Practice address
- 3301 Bienville Blvd
Ocean Springs, MS 39564-4318 - Phone
- (228) 818-1111
- NPI assigned
- Feb 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R726397 | MS | Primary |
Addresses
Primary practice location
3301 Bienville Blvd
Ocean Springs, MS 39564-4318
Mailing address
P O Box 3488
Dept 05-113
Tupelo, MS 38803-3488
Phone (678) 553-8150
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 430071927 | Other | RAILROAD MEDICARE | |
| 640942692 | Other | BLUE CROSS OF MS | |
| KD00016173 | Medicaid | MS |
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)
- Enrolled
- Credentials
- Certified Registered Nurse
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504224000000",
"number": "1457486755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 3488",
"address_2": "DEPT 05-113",
"city": "TUPELO",
"state": "MS",
"postal_code": "388033488",
"telephone_number": "678-553-8150",
"fax_number": "678-553-8152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3301 BIENVILLE BLVD",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "395644318",
"telephone_number": "228-818-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANOS",
"first_name": "KENNON",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-23",
"last_updated": "2017-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MS",
"license": "R726397",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "430071927",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF MS",
"identifier": "640942692",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "KD00016173",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ocean Springs, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.