Kenneth Joseph Imboden, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

130809 Issued in NY

Practice address

153 W Genesee St
Upper Level
Chittenango, NY 13037-1528

Phone

(315) 687-5100

Fax

(315) 687-0252

NPI assigned

Jun 11, 2006

Last updated

Mar 27, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1467494013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 W GENESEE ST",
            "address_2": "UPPER LEVEL",
            "city": "CHITTENANGO",
            "state": "NY",
            "postal_code": "130371528",
            "telephone_number": "315-687-5100",
            "fax_number": "315-687-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 W GENESEE ST",
            "address_2": "UPPER LEVEL",
            "city": "CHITTENANGO",
            "state": "NY",
            "postal_code": "130371528",
            "telephone_number": "315-687-5100",
            "fax_number": "315-687-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMBODEN",
        "first_name": "KENNETH",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "130809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert T Friedman, MD
• Bridget A Frio, O.D.
• Nancy Helen Gaskill, PA
• William Oskar Groetz, D.C.
• Linda B Harrington, PT
• Charles Louis Ingerson, R.N.
• John Jackson
• Tiffany Nicole Jackson, LMHC
• Whitney King
• Daniel G Kingsley, PT, OCS, COMT, CSCS

• Internal Medicine Physician in Chittenango, NY
• Providers in Chittenango, NY by specialty
• Internal Medicine Physician in New York

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