NPIMap

Individual provider Active NPI

Kenneth Fox

  • Driver
  • Champlin, MN
National Provider Identifier
1487095469
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
0561 Issued in FL
Practice address
8562 122ND Ave N
Champlin, MN 55316-3588
Phone
(612) 867-6629
NPI assigned
Jul 8, 2013
Last updated
Jul 8, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X 0561 FL Primary

Addresses

Primary practice location

8562 122ND Ave N
Champlin, MN 55316-3588

Mailing address

8562 122ND Ave N
Champlin, MN 55316-3588
Phone (612) 867-6629

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0561FLMDDriver

Practice roles

OrganizationSpecialtyStatusNew patients
Express Air Medical Transport, LLC Current Accepting new patients
Express Aviation Services, Inc. Current Accepting new patients
All Care Medtran, LLC Current Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1487095469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8562 122ND AVE N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553163588",
            "telephone_number": "612-867-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8562 122ND AVE N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553163588",
            "telephone_number": "612-867-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "KENNETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-08",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "FL",
            "license": "0561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champlin, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.