Gideon Kazah

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

318240-31 Issued in WI

Practice address

2488 Dahle Street
Madison, WI 53704

Phone

(917) 346-4459

NPI assigned

Dec 15, 2015

Last updated

Dec 15, 2015By the provider in NPPES

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 1

Other names 1

• Gideon Kazah Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1831554021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2488 DAHLE STREET",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53704",
            "telephone_number": "917-346-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2488 DAHLE STREET",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53704",
            "telephone_number": "917-346-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZAH",
        "first_name": "GIDEON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-15",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "318240-31",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318240-31",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GIDEON",
            "last_name": "KAZAH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Brittany Gillard Kawas, DDS
• Jonathan Kay, M.D.
• Marilyn C Kay, MD
• Jesse Tukman Kaye, PHD
• Brian Kayon
• Martin Keane, MSSW, APSW, LCSW
• Anna Keaney
• Andrea Renee Keapproth, LMT
• Laura Helen Kearney, LCSW
• Abigail E. Kearns

• Licensed Practical Nurse in Madison, WI
• Providers in Madison, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; 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.