Individual provider Active NPI

Kenneth Oshiokhayamhe Etokhana, M.D

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1629233127
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P2438 Issued in TX
Practice address
6735 FM 78 Ste 102
San Antonio, TX 78244-1368
Phone
(210) 888-9960
Fax
(210) 888-9422
NPI assigned
Jul 23, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P2438 TX Primary

Addresses

Primary practice location

6735 FM 78 Ste 102
San Antonio, TX 78244-1368

Mailing address

6735 FM 78 Ste 102
San Antonio, TX 78244-1368
Phone (210) 888-9960

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

LicenseStateTypeSpecialty
P2438TXMDPediatrics Physician
003972NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
VHS San Antonio Partners LLC Past Accepting new patients
Neo2Teen Pediatric Clinic, PA Pediatrics PastSince Nov 9, 2025 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15846/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kenneth.etokhana.1@15846.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1629233127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6735 FM 78 STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782441368",
            "telephone_number": "210-888-9960",
            "fax_number": "210-888-9422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6735 FM 78 STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782441368",
            "telephone_number": "210-888-9960",
            "fax_number": "210-888-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETOKHANA",
        "first_name": "KENNETH",
        "middle_name": "OSHIOKHAYAMHE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-23",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P2438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; 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.