Individual provider Active NPI

Kenneth D Murray, M.D.

  • Family Medicine Physician
  • Burbank, CA
National Provider Identifier
1720029481
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G50230 Issued in CA
Practice address
2061 W Alameda Ave
Suite 111
Burbank, CA 91506-2932
Phone
(818) 295-5920
Fax
(818) 295-6965
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G50230 CA Primary

Addresses

Primary practice location

2061 W Alameda Ave
Suite 111
Burbank, CA 91506-2932

Mailing address

777 Flower St
Suite a
Glendale, CA 91201-3015
Phone (818) 637-2000

Other identifiers 1

IdentifierTypeStateIssuer
00G502300MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Medical Associates, a Medical Group, Inc. Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kenneth.murray.p1@direct.lakeside.nextgenshare.com

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190332800000",
    "number": "1720029481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 FLOWER ST",
            "address_2": "SUITE A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912013015",
            "telephone_number": "818-637-2000",
            "fax_number": "818-242-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 W ALAMEDA AVE",
            "address_2": "SUITE 111",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062932",
            "telephone_number": "818-295-5920",
            "fax_number": "818-295-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "KENNETH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2007-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G50230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G502300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; 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.