Kenneth E McIntyre, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

10314 Issued in NV

Practice address

1707 W Charleston Blvd
#160, Patient Care Center
Las Vegas, NV 89102-2351

Phone

(702) 671-5150

Fax

(702) 684-6493

NPI assigned

Jan 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1740268556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 W CHARLESTON BLVD",
            "address_2": "#601",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022227",
            "telephone_number": "702-671-2274",
            "fax_number": "702-384-7506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 W CHARLESTON BLVD",
            "address_2": "#160, PATIENT CARE CENTER",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022351",
            "telephone_number": "702-671-5150",
            "fax_number": "702-684-6493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "KENNETH",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NV",
            "license": "10314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018582",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY/CDS",
            "identifier": "CS11417",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel McIntosh
• Raymond Nathan McIntosh
• Rose Marie McIntosh, FNPC CS
• Janaya McIntyre-Kaina
• Alaina McIntyre
• Rebecca McIntyre
• Richard Matthew McIntyre, D.C.
• Roberta McIntyre
• Sheila Christine McIntyre
• Sidney McIntyre

• Vascular Surgery Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Vascular Surgery Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.