Innovative Apn LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP118688 Issued in TX

Legal business name

INNOVATIVE APN LLC

Doing business as

Kenneth Tam

Practice address

9301 Elm Grove Cir
Austin, TX 78736-7716

Phone

(512) 291-8076

Fax

(512) 590-7104

NPI assigned

Jul 27, 2016

Last updated

Jul 28, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Tam, NP-C

Title

Nurse Practitioner

Phone

(512) 291-8076

Specialties & licenses 1

Addresses

Other names 1

• Kenneth Tam Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cynthia C Lorenzetti, NP

  • Nurse Practitioner
  • Winston Salem, NC
  • NPI 1972670438
  NPD (past)

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469664000000",
    "number": "1710430509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 ELM GROVE CIR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787367716",
            "telephone_number": "512-291-8076",
            "fax_number": "512-590-7104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 ELM GROVE CIR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787367716",
            "telephone_number": "512-291-8076",
            "fax_number": "512-590-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE APN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-07-28",
        "status": "A",
        "authorized_official_last_name": "TAM",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "512-291-8076",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP118688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenneth Tam",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Nurse Practitioner in Austin, TX
• Providers in Austin, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.