NPIMap

Organization Active NPI

Kaner Medical Group PA

  • Internal Medicine Physician
  • Bedford, TX
National Provider Identifier
1639169295
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
KANER MEDICAL GROUP PA
Practice address
1305 Airport Fwy
Ste 220
Bedford, TX 76021-6605
Phone
(817) 358-5800
Fax
(817) 283-7686
NPI assigned
Oct 25, 2005
Last updated
Apr 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Authorized official

Name
Judith Kutler
Title
Ceo
Phone
(817) 358-5800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

1305 Airport Fwy
Ste 220
Bedford, TX 76021-6605

Mailing address

PO Box 210907
Kaner Medical Group PA
Bedford, TX 76095-7907
Phone (817) 358-5800

Other identifiers 1

IdentifierTypeStateIssuer
155952801MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1639169295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 210907",
            "address_2": "KANER MEDICAL GROUP PA",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760957907",
            "telephone_number": "817-358-5800",
            "fax_number": "817-283-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 AIRPORT FWY",
            "address_2": "STE 220",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760216605",
            "telephone_number": "817-358-5800",
            "fax_number": "817-283-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANER MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "KUTLER",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-358-5800"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155952801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.