Kenneth G. Lawlor, DO, PLLC

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

5487 Issued in AZ

Legal business name

KENNETH G. LAWLOR, DO, PLLC

Practice address

3120 Clearwater Dr
Prescott, AZ 86305-7131

Phone

(928) 717-8838

Fax

(928) 717-8832

NPI assigned

Jul 27, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Gayle Lawlor, DONPI 1902917289

Title

Ownerphysician

Phone

(928) 717-8838

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Kenneth G. Lawlor, DO, PLLC

  • Rheumatology Physician
  • Phoenix, AZ
  • NPI 1255955191

  O20101202000098

  Same enrollment

Tax ID family

Canyon State Rheumatology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kenneth G. Lawlor, DO, PLLC

  • Rheumatology Physician
  • Phoenix, AZ
  • NPI 1255955191
  NPD tax ID

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth Gayle Lawlor, DO

  • Rheumatology Physician
  • Prescott, AZ
  • NPI 1902917289
  Medicare reassignment Care Compare group NPD Authorized official
• Jason Frank Pace, PA

  • Medical Physician Assistant
  • Show Low, AZ
  • NPI 1932423381
  Medicare reassignment Care Compare group
• Joanna Mae Taylor, FNP

  • Family Nurse Practitioner
  • Peoria, AZ
  • NPI 1972015998
  Medicare reassignment NPD
• Tammy Lynn Tunis, FNP

  • Family Nurse Practitioner
  • Prescott, AZ
  • NPI 1447809926

  Single Specialty

  Medicare reassignment NPD
• Stephanie Maurer

  • Medical Physician Assistant
  • Prescott, AZ
  • NPI 1275004186
  Medicare reassignment
• Sabine Dorothy Docteur, MD PA MBA MSC.

  • Physician Assistant
  • Auburndale, FL
  • NPI 1578210399

  AZ

  Medicare reassignment

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280188800000",
    "number": "1801100250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4343",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863024343",
            "telephone_number": "928-717-8838",
            "fax_number": "928-717-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 CLEARWATER DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057131",
            "telephone_number": "928-717-8838",
            "fax_number": "928-717-8832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH G. LAWLOR, DO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-27",
        "last_updated": "2010-07-27",
        "status": "A",
        "authorized_official_last_name": "LAWLOR",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "GAYLE",
        "authorized_official_title_or_position": "OWNERPHYSICIAN",
        "authorized_official_telephone_number": "928-717-8838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "AZ",
            "license": "5487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LIC",
            "identifier": "5487",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Kay Kelsey, LCSW
• Hai CHI Keng, M.D.
• Aileen Marie Kennedy, M.D.
• Laura Dee Kennedy, NMD
• Rovena R Kennedy, LDO
• Julia Catherine Kennison, APRN, FNP-C
• Erin Lynn Kerr, DNP, APRN-CNP
• Scott Kerr, MSW, LCSW
• Kevin S Doyle MD PLLC
• Janie Kewenvoyouma, LMSW

• Rheumatology Physician in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Rheumatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.