Kenilworth Surgery Center LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A1367 Issued in MD

Legal business name

KENILWORTH SURGERY CENTER LLC

Practice address

1104 Kenilworth Dr
Ste 201
Towson, MD 21204

Phone

(443) 279-0340

Fax

(443) 279-0343

NPI assigned

Dec 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Stanley J Miller, MDNPI 1841240470

Title

Medical Director

Phone

(443) 279-0340

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Listed as

Kenilworth Surgery Center LLCCCN 21C0001367

Medicare certification status

ActiveFrom the Provider of Services file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Ra Schleichert MD PA

  • MOHS-Micrographic Surgery Physician
  • Towson, MD
  • NPI 1821130246

  Member Of

  NPD member

Locations

Practitioners 3

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

• Stanley Joseph Miller, M.D.

  • Dermatology Physician
  • Towson, MD
  • NPI 1841240470
  NPD (past) Authorized official
• Rachel A Schleichert, MD

  • MOHS-Micrographic Surgery Physician
  • Baltimore, MD
  • NPI 1679708416
  NPD (past)
• Arianna Yanes, MD

  • Dermatology Physician
  • Boston, MA
  • NPI 1225402100
  NPD (past)

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373414400000",
    "number": "1801952346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 KENILWORTH DR",
            "address_2": "STE 201",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "21204",
            "telephone_number": "443-279-0340",
            "fax_number": "443-279-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 KENILWORTH DR",
            "address_2": "STE 201",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "21204",
            "telephone_number": "443-279-0340",
            "fax_number": "443-279-0343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENILWORTH SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2013-07-10",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "443-279-0340",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MD",
            "license": "A1367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raechelle Lynn Kempfer, NP
• Ken Zeigler, LLC
• Laura Kendal, LCPC, CAC-AD
• Phillip Kendall
• Victoria Louise Kendall, BACB
• Kenneth B. Singleton, M.D.
• Kenneth J. Murray, P.a.
• Kenneth Tilles, O.D., P.a.
• Jaclyn J Kenney
• Jamia Kent

• Surgery Physician in Towson, MD
• Providers in Towson, MD by specialty
• Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.