Active NPI
Robert E Kane III, MD
- Pediatrics Physician
- Glen Allen, VA
National Provider Identifier
1740386911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- R8H17
- Practice address
- 10632 Toston LN
Glen Allen, VA 23060-6498 - Phone
- (804) 475-2437
- Fax
- (804) 747-4304
- NPI assigned
- Sep 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R8H17 | MO | Primary |
| Pediatric Gastroenterology Physician | 2080P0206X | 29238 | OK |
Addresses
Primary practice location
10632 Toston LN
Glen Allen, VA 23060-6498
Mailing address
10632 Toston LN
Glen Allen, VA 23060-6498
Phone (804) 475-2437
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202531802 | Medicaid | MO |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 29238 | OK | MD | Pediatric Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485907200000",
"number": "1740386911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10632 TOSTON LN",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230606498",
"telephone_number": "804-475-2437",
"fax_number": "804-747-4304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10632 TOSTON LN",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230606498",
"telephone_number": "804-475-2437",
"fax_number": "804-747-4304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANE",
"first_name": "ROBERT",
"middle_name": "E",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-15",
"last_updated": "2017-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "R8H17",
"primary": true
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "OK",
"license": "29238",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202531802",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Glen Allen, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.