Kenneth R Harley, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

C32910 Issued in CA

Practice address

13851 E 14TH St
Suite 102
San Leandro, CA 94578-2631

Phone

(510) 351-2100

NPI assigned

Feb 3, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• State of Alaska Department of Administration

  • Psychiatric Hospital
  • Anchorage, AK
  • NPI 1497842553
  NPD (past)

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262131200000",
    "number": "1558333443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13851 E 14TH ST",
            "address_2": "SUITE 102",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782631",
            "telephone_number": "510-351-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13851 E 14TH ST",
            "address_2": "SUITE 102",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782631",
            "telephone_number": "510-351-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARLEY",
        "first_name": "KENNETH",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2009-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C32910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcelliese Teshalarae Hardin
• Tamelah Hardley
• Sydney Hardman
• Ashlle Hardy
• Harley S Schultz MD & Vladimir a Titov MD PHD Inc
• Tori Jo Harmon
• Harmony Health & Wellness Center
• Emily Alexandra Ansted Harrington
• Kristen Harrington
• Cyndi A Harris Edwards, PHLEBOTOMIST

• Emergency Medicine Physician in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2009; 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.