Kenneth L Poag, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

8286 Issued in TN

Practice address

2001 Mallory LN
Franklin, TN 37067-8233

Phone

(615) 771-1940

Fax

(615) 771-1984

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246924800000",
    "number": "1770515801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MALLORY LN",
            "address_2": "SUITE 103",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370678233",
            "telephone_number": "615-771-1940",
            "fax_number": "615-771-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MALLORY LN",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370678233",
            "telephone_number": "615-771-1940",
            "fax_number": "615-771-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POAG",
        "first_name": "KENNETH",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2009-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "8286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4040148",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STONES RIVER IPA",
            "identifier": "3089723",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICAID",
            "identifier": "64745870",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3155534",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Demtrica D Pittman, BEHAVIOR TECHNICIANS
• Gayle S Pitts, FNP
• Hilary Roy Pitts, R.D.
• Karsen Plantamura, PHARMD
• Plastic Surgery Clinic, PLLC
• Podiatric Minimally Invasive Surgery Center
• Rebekah Pogue, MMFT
• Selena Elizabeth Polgardy
• Politzer Consulting Group LLC
• Michael R Politzer, O.D.

• Emergency Medicine Physician in Franklin, TN
• Providers in Franklin, TN by specialty
• Emergency Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2009; 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.