Kenneth R Purdom II, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A21180 Issued in CA

Practice address

6354 Painter Ave
Whittier, CA 90601-4632

Phone

(562) 698-0948

Fax

(562) 698-7058

NPI assigned

Dec 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: kpurdom630384@direct.ochin.org

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

• Kenneth R Purdom II MD Inc

  • Specialist
  • Whittier, CA
  • NPI 1649519646
  Medicare reassignment NPD Authorized official
• Ahmc Whittier Hospital Medical Center LP

  • Medicare Defined Swing Bed Hospital Unit
  • Whittier, CA
  • NPI 1497855605
  NPD (past)
• Friends of Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Ontario, CA
  • NPI 1003546342
  NPD (past)
• Friends of Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Pico Rivera, CA
  • NPI 1124758727
  NPD (past)
• Friends of Family Health Center

  • Federally Qualified Health Center (FQHC)
  • La Puente, CA
  • NPI 1124758883
  NPD (past)
• Pih Health Whittier Hospital

  • General Acute Care Hospital
  • Whittier, CA
  • NPI 1043215379
  NPD (past)
• Northeast Hospital Corporation

  • General Acute Care Hospital
  • Beverly, MA
  • NPI 1316917941
  NPD (past)

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377734400000",
    "number": "1497819361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6354 PAINTER AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906014632",
            "telephone_number": "562-698-0948",
            "fax_number": "562-698-7058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6354 PAINTER AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906014632",
            "telephone_number": "562-698-0948",
            "fax_number": "562-698-7058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURDOM",
        "first_name": "KENNETH",
        "middle_name": "R",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2013-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A21180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A21180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Ronald Pulera, M.D.
• Mario Alberto Pulido, DC
• Daniel William Puls, PSY.D.
• Janine M. Puls, LCSW
• Kendra Rea Purdom Ramirez, NP
• Amanda C Purdy, MD
• Pure Melody Hospice Inc
• Sanjeev Puri, D.O
• Shailja Purohit
• Arielle Putan Duong

• Obstetrics & Gynecology Physician in Whittier, CA
• Providers in Whittier, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.