Individual provider Active NPI

Trevor Kench, LPN

  • Licensed Practical Nurse
  • Potsdam, NY
National Provider Identifier
1669760369
Registry record updated Jul 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
305426 Issued in NY
Practice address
56 Market St
Potsdam, NY 13676-1747
Phone
(315) 265-4065
Fax
(315) 265-0012
NPI assigned
Jul 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 305426 NY Primary

Addresses

Primary practice location

56 Market St
Potsdam, NY 13676-1747

Mailing address

56 Market St
Potsdam, NY 13676-1747
Phone (315) 265-4065

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
305426NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services of Northern New York Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310601600000",
    "number": "1669760369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 MARKET ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761747",
            "telephone_number": "315-265-4065",
            "fax_number": "315-265-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 MARKET ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761747",
            "telephone_number": "315-265-4065",
            "fax_number": "315-265-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENCH",
        "first_name": "TREVOR",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-14",
        "last_updated": "2011-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "305426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potsdam, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; 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.