Active NPI
Kenneth Elwood, RN, CMT
- Pain Management Registered Nurse
- Fostoria, MI
National Provider Identifier
1679743298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Management Registered Nurse
- License
- 4704202174
- Practice address
- 1673 W Millington Rd
Fostoria, MI 48435-9725 - Phone
- (989) 795-2641
- NPI assigned
- Mar 11, 2008
- Last updated
- Mar 11, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pain Management Registered Nurse | 163WP0000X | 4704202174 | MI | Primary |
Addresses
Primary practice location
1673 W Millington Rd
Fostoria, MI 48435-9725
Mailing address
1673 W Millington Rd
Fostoria, MI 48435-9725
Phone (989) 795-2641
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704202174 | MI | MD | Pain Management Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205193600000",
"number": "1679743298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1673 W MILLINGTON RD",
"city": "FOSTORIA",
"state": "MI",
"postal_code": "484359725",
"telephone_number": "989-795-2641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1673 W MILLINGTON RD",
"city": "FOSTORIA",
"state": "MI",
"postal_code": "484359725",
"telephone_number": "989-795-2641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELWOOD",
"first_name": "KENNETH",
"name_prefix": "Mr.",
"credential": "RN, CMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-11",
"last_updated": "2008-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pain Management",
"state": "MI",
"license": "4704202174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fostoria, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.