Individual provider Active NPI

Kenneth Richard Kindle, D.O.

  • Family Medicine Physician
  • Killeen, TX
National Provider Identifier
1467412395
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H8178 Issued in TX
Practice address
5702 E Central Texas Expy
Killeen, TX 76543-5500
Phone
(254) 680-7300
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H8178 TX Primary

Addresses

Primary practice location

5702 E Central Texas Expy
Killeen, TX 76543-5500

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Other practice location 1

3801 Scott and White Dr
Killeen, TX 76543-5252
Phone (254) 680-1100

Other identifiers 1

IdentifierTypeStateIssuer
86J230OtherTXBLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkindle14172@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100324000863 TX Practitioner - Family Practice 3274669676

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Interoperability endpoints

  • Direct secure messaging: kkindle14172@direct.sw.org

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1467412395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5702 E CENTRAL TEXAS EXPY",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765435500",
            "telephone_number": "254-680-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Scott and White Dr",
            "address_purpose": "LOCATION",
            "city": "Killeen",
            "state": "TX",
            "postal_code": "765435252",
            "country_code": "US",
            "telephone_number": "254-680-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINDLE",
        "first_name": "KENNETH",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H8178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "86J230",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkindle14172@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5702 E Central Texas Expy",
            "city": "Killeen",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765435500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

Verify at the official NPI Registry.