Active NPI
Kenneth Vernon Eden, MD
- Gastroenterology Physician
- Helena, MT
National Provider Identifier
1598863904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 3711
- Practice address
- 2525 Broadway
Suite 200
Helena, MT 59601 - Phone
- (406) 457-4343
- Fax
- (406) 457-4344
- NPI assigned
- Sep 20, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 3711 | MT | Primary |
Addresses
Primary practice location
2525 Broadway
Suite 200
Helena, MT 59601
Mailing address
P.O. Box 6369
Helena, MT 59604
Phone (406) 447-2828
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16771 | Other | MT | BCBS OF MT |
| 0142477 | Medicaid | MT |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3711 | MT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598863904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 6369",
"city": "HELENA",
"state": "MT",
"postal_code": "59604",
"telephone_number": "406-447-2828",
"fax_number": "406-447-2825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 BROADWAY",
"address_2": "SUITE 200",
"city": "HELENA",
"state": "MT",
"postal_code": "59601",
"telephone_number": "406-457-4343",
"fax_number": "406-457-4344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDEN",
"first_name": "KENNETH",
"middle_name": "VERNON",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MT",
"license": "3711",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MT",
"identifier": "16771",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0142477",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Helena, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.