Kenneth N. Azan, M.D., PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

R6443 Issued in MO

Legal business name

KENNETH N. AZAN, M.D., PC

Practice address

1718 S Ingram Ave
Suite C
Sedalia, MO 65301-7505

Phone

(660) 827-2535

Fax

(660) 826-5228

NPI assigned

Apr 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Najeeb Azan, M.D.

Title

President

Phone

(660) 827-2535

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leah Hermanson, NP-C

  • Nurse Practitioner
  • Sedalia, MO
  • NPI 1063959518
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689796369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 S INGRAM AVE",
            "address_2": "SUITE C",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653017505",
            "telephone_number": "660-827-2535",
            "fax_number": "660-826-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 S INGRAM AVE",
            "address_2": "SUITE C",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653017505",
            "telephone_number": "660-827-2535",
            "fax_number": "660-826-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH N. AZAN, M.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AZAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "NAJEEB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "660-827-2535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R6443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD KC",
            "identifier": "06594013",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kent Allan Keethler, DDS
• Heather Keith
• Jeffrey Keller, DPT
• Stephanie Kelley, PHARMD
• Kathy J. Kempton, LPC
• Darby William Kernohan, RPH
• Kevin K.E. Carl, O.D.
• Connie E Kiburz, CRNA
• Douglas W Kiburz, MD
• Michelle Ann Kindler, O.D.

• All providers in Sedalia, MO
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.