Individual provider Active NPI

Kenneth H Hurder

  • Licensed Practical Nurse
  • Indianapolis, IN
National Provider Identifier
1811224512
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
27037482A Issued in IN
Practice address
8702 E 86TH St
Indianapolis, IN 46256-1340
Phone
(317) 849-4615
Fax
(317) 849-9758
NPI assigned
Nov 17, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 27037482A IN Primary

Addresses

Primary practice location

8702 E 86TH St
Indianapolis, IN 46256-1340

Mailing address

8702 E 86TH St
Indianapolis, IN 46256-1340
Phone (317) 849-4615

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27037482AINMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1811224512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8702 E 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561340",
            "telephone_number": "317-849-4615",
            "fax_number": "317-849-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8702 E 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561340",
            "telephone_number": "317-849-4615",
            "fax_number": "317-849-9758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURDER",
        "first_name": "KENNETH",
        "middle_name": "H",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-17",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IN",
            "license": "27037482A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.