Kenneth K Oh, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

41268020 Issued in WI

Practice address

2817 New Pinery Rd.
Divine Savior Healthcare Inc
Portage, WI 53901-0387

Phone

(608) 742-4131

Fax

(608) 742-0362

NPI assigned

Nov 22, 2005

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

Other identifiers 1

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1538142765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY RD.",
            "address_2": "DIVINE SAVIOR HEALTHCARE INC",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539010387",
            "telephone_number": "608-742-4131",
            "fax_number": "608-742-0362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY RD.",
            "address_2": "DIVINE SAVIOR HEALTHCARE INC",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539010387",
            "telephone_number": "608-742-4131",
            "fax_number": "608-742-0362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OH",
        "first_name": "KENNETH",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "41268020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32590300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Lynn Niles, M.S.S.W. CAPSW
• Laura L Noonan, APNP
• Northwoods Inc of Wisconsin
• Dirk M Nuenninghoff, MD
• Kathleen M O'Reilly, P.T.
• Amy Olson
• Matthew Richard Olson, DDS
• Amy Jo Orlowski, P.T.A.
• Karen D Orr, PA-C
• Ashton Osness

• Physical Medicine & Rehabilitation Physician in Portage, WI
• Providers in Portage, WI by specialty
• Physical Medicine & Rehabilitation Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2012; 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.