NPIMap

Individual provider Active NPI

Kenneth D Paige, DO

  • Family Medicine Physician
  • Sun Lakes, AZ
National Provider Identifier
1487645685
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3169 Issued in AZ
Practice address
10450 E Riggs Rd #114
Sun Lakes, AZ 85248-7760
Phone
(480) 505-2450
Fax
(480) 505-2465
NPI assigned
Nov 4, 2005
Last updated
Feb 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 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 3169 AZ Primary

Addresses

Primary practice location

10450 E Riggs Rd #114
Sun Lakes, AZ 85248-7760

Mailing address

10450 E Riggs Rd #114
Sun Lakes, AZ 85248-7760
Phone (480) 505-2450

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060718000223 AZ Practitioner - Family Practice 9436144938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Nova Southeastern College of Osteo Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Access Wellness ResourcesGroup PAC ID 6002296506, 37 clinicians

Practice addresses (Care Compare)

10450 E Riggs Rd
Suite 114
Sun Lakes, AZ 85248-7760
Phone (480) 505-2450

3501 N Scottsdale Rd
Suite 231
Scottsdale, AZ 85251-5649
Phone (855) 893-5637

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23169AZMDMental Health Counselor
3169AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Access Wellness Resources Family Medicine CurrentSince Apr 7, 2024 Accepting new patients
Sun Lakes Family Physicians LLC Family Medicine CurrentSince May 1, 2001 Accepting new patients
Sun Lakes Health Care, PC Past Accepting new patients

Locations

3501 N Scottsdale Rd
Ste 231
Scottsdale, AZ 85251
Phone (480) 882-4770

10450 E Riggs Rd
Ste 114
Sun Lakes, AZ 85248
Phone (480) 505-2450

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27041/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kenneth.paige.1@27041.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1487645685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10450 E RIGGS RD #114",
            "city": "SUN LAKES",
            "state": "AZ",
            "postal_code": "852487760",
            "telephone_number": "480-505-2450",
            "fax_number": "480-505-2465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 E RIGGS RD #114",
            "city": "SUN LAKES",
            "state": "AZ",
            "postal_code": "852487760",
            "telephone_number": "480-505-2450",
            "fax_number": "480-505-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAIGE",
        "first_name": "KENNETH",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "3169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun Lakes, AZ

Sources for this page

Verify at the official NPI Registry.