JKN Medical Support Group LLC

Primary specialty

Private VehicleTaxonomy code 347C00000X

Legal business name

JKN MEDICAL SUPPORT GROUP LLC

Practice address

13250 Emily Rd Apt 1006
Dallas, TX 75240-5953

Phone

(316) 409-3022

NPI assigned

Jul 14, 2016

Organization subpart

No

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

Authorized official

Name

Kenneth Bethel

Title

Owner

Phone

(316) 409-3022

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468454400000",
    "number": "1679926620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13250 EMILY RD APT 1006",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752405953",
            "telephone_number": "316-409-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13250 EMILY RD APT 1006",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752405953",
            "telephone_number": "316-409-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JKN MEDICAL SUPPORT GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A",
        "authorized_official_last_name": "BETHEL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-409-3022"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Private Vehicle in Dallas, TX
• Providers in Dallas, TX by specialty
• Private Vehicle in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.