Active NPI
Kenneth James Westrate, M.D.
- Emergency Medicine Physician
- Parker, AZ
National Provider Identifier
1568564326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 4301046165
- Practice address
- 12033 Agency Rd
Parker, AZ 85344-7718 - Phone
- (928) 669-2137
- Fax
- (928) 669-3131
- NPI assigned
- Sep 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 4301046165 | MI | Primary |
| Pediatrics Physician | 208000000X | 4301046165 | MI | |
| General Practice Physician | 208D00000X | 4301046165 | MI |
Addresses
Primary practice location
12033 Agency Rd
Parker, AZ 85344-7718
Mailing address
1310 Calimesa CT
Lake Havasu City, AZ 86406-8045
Phone (616) 855-0526
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 717845 | Medicaid | AZ |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS IHS Phoenix Area | Past | Accepting new patients | |
| Spectrum Health United | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Federal Public Health Clinic/Center
- Havasu Lake, CA
- NPI 1396022026
-
- General Acute Care Hospital
- Greenville, MI
- NPI 1457304495
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375228800000",
"number": "1568564326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1310 CALIMESA CT",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864068045",
"telephone_number": "616-855-0526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12033 AGENCY RD",
"city": "PARKER",
"state": "AZ",
"postal_code": "853447718",
"telephone_number": "928-669-2137",
"fax_number": "928-669-3131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESTRATE",
"first_name": "KENNETH",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-02",
"last_updated": "2013-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MI",
"license": "4301046165",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301046165",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MI",
"license": "4301046165",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "717845",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Parker, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.