Active NPI
Kenneth Arthur Hoose Jr., M.D.
- Cardiovascular Disease Physician
- Decatur, GA
National Provider Identifier
1811959364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 10962
- Practice address
- 2675 N Decatur Rd
Suite 607
Decatur, GA 30033-6131 - Phone
- (404) 501-7640
- Fax
- (404) 501-7601
- NPI assigned
- Apr 3, 2006
- Last updated
- Feb 28, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 10962 | GA | Primary |
Addresses
Primary practice location
2675 N Decatur Rd
Suite 607
Decatur, GA 30033-6131
Mailing address
2675 N Decatur Rd
Suite 607
Decatur, GA 30033-6131
Phone (404) 501-7640
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00098876A | Medicaid | GA | |
| 048575 | Other | GA | BLUE SHIELD |
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 |
|---|---|---|---|
| 10962 | GA | MD | Cardiovascular Disease Physician |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Cardiovascular Disease Physician
- Decatur, GA
- NPI 1396921417
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204156800000",
"number": "1811959364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2675 N DECATUR RD",
"address_2": "SUITE 607",
"city": "DECATUR",
"state": "GA",
"postal_code": "300336131",
"telephone_number": "404-501-7640",
"fax_number": "404-501-7601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2675 N DECATUR RD",
"address_2": "SUITE 607",
"city": "DECATUR",
"state": "GA",
"postal_code": "300336131",
"telephone_number": "404-501-7640",
"fax_number": "404-501-7601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOOSE",
"first_name": "KENNETH",
"middle_name": "ARTHUR",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-03",
"last_updated": "2008-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "GA",
"license": "10962",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00098876A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "048575",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.