Active NPI
Kenneth Richard Lawrence, DPM
- Podiatrist
- Farmington Hills, MI
National Provider Identifier
1639183130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- KL000565
- Practice address
- 30335 W 13 Mile Rd Ste 100
Farmington Hills, MI 48334 - Phone
- (248) 476-1616
- Fax
- (248) 476-6683
- NPI assigned
- Jul 28, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | KL000565 | MI | Primary |
Addresses
Primary practice location
30335 W 13 Mile Rd Ste 100
Farmington Hills, MI 48334
Mailing address
24300 Orchard Lake Rd
Farmington Hills, MI 48336
Phone (248) 476-1616
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1243424 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KL000565 | MI | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527552000000",
"number": "1639183130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24300 ORCHARD LAKE RD",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "48336",
"telephone_number": "248-476-1616",
"fax_number": "248-476-6683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30335 W 13 MILE RD STE 100",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "48334",
"telephone_number": "248-476-1616",
"fax_number": "248-476-6683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAWRENCE",
"first_name": "KENNETH",
"middle_name": "RICHARD",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2018-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MI",
"license": "KL000565",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1243424",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.