Individual provider Active NPI

Kendall Zinsser, MD

  • Clinical Pathology/Laboratory Medicine Physician
  • Lebanon, PA
National Provider Identifier
1487633129
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
MD021537E Issued in PA
Practice address
4TH and Walnut St
Lebanon, PA 17042
Phone
(610) 568-1380
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X MD021537E PA Primary

Addresses

Primary practice location

4TH and Walnut St
Lebanon, PA 17042

Mailing address

2 Meridian Blvd
2ND Floor
Wyomissing, PA 19610-3202
Phone (610) 568-1380

Other identifiers 1

IdentifierTypeStateIssuer
0011368270001MedicaidPA

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD021537EPAMDClinical Pathology/Laboratory Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1487633129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MERIDIAN BLVD",
            "address_2": "2ND FLOOR",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103202",
            "telephone_number": "610-568-1380",
            "fax_number": "610-372-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4TH AND WALNUT ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "17042",
            "telephone_number": "610-568-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZINSSER",
        "first_name": "KENDALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "PA",
            "license": "MD021537E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011368270001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.