NPIMap

Individual provider Active NPI

Kenneth David Hopper, M.D.

  • Specialist
  • Kent, OH
National Provider Identifier
1740219112
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD040093E Issued in PA
Practice address
1930 State Route 59
Kent, OH 44240-4112
Phone
(330) 677-3632
Fax
(330) 677-8770
NPI assigned
Jun 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD040093E PA Primary

Addresses

Primary practice location

1930 State Route 59
Kent, OH 44240-4112

Mailing address

1675 E Main St
Box 328
Kent, OH 44240-5818
Phone (330) 677-3632

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

State licenses

LicenseStateTypeSpecialty
MD040093EPAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Penn Imaging Associates PC Past Accepting new patients
Albert J. Cook M.D. Inc Past Accepting new patients
Lewistown Ambulatory Care Corp Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740219112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 E MAIN ST",
            "address_2": "BOX 328",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442405818",
            "telephone_number": "330-677-3632",
            "fax_number": "330-677-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 STATE ROUTE 59",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404112",
            "telephone_number": "330-677-3632",
            "fax_number": "330-677-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOPPER",
        "first_name": "KENNETH",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD040093E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.