Rod D Kack, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

M6895 Issued in ID

Practice address

706 N College Rd Ste C
Twin Falls, ID 83301-5824

Phone

(208) 735-1000

Fax

(208) 732-5345

NPI assigned

Jan 25, 2007

Last updated

Feb 6, 2012By the provider in NPPES

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

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

• Snake River Ear, Nose & Throat PC

  • Specialist
  • Twin Falls, ID
  • NPI 1104912740
  Authorized official Same address or phone

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1629123815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 N COLLEGE RD STE C",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015824",
            "telephone_number": "208-735-1000",
            "fax_number": "208-732-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 N COLLEGE RD STE C",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015824",
            "telephone_number": "208-735-1000",
            "fax_number": "208-732-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACK",
        "first_name": "ROD",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ID",
            "license": "M6895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805168100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Katelyn Schwennen PLLC (Cactus Bloom Therapy)

• Specialist in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Specialist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.