Active NPI
Kenneth Harry Markiewicz, DO
- Otolaryngology Physician
- Carson City, MI
National Provider Identifier
1851359178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 5101007662
- Practice address
- 102 S 3Rd St
Ste 200
Carson City, MI 48811-5115 - Phone
- (989) 584-0932
- Fax
- (989) 584-0918
- NPI assigned
- May 3, 2006
- Last updated
- Mar 20, 2016
- 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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 5101007662 | MI | Primary |
Addresses
Primary practice location
102 S 3Rd St
Ste 200
Carson City, MI 48811-5115
Mailing address
102 S 3Rd St
Ste 200
Carson City, MI 48811-5115
Phone (989) 584-0932
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0454111024 | Other | MI | BCBSM |
| 1642877 | Medicaid | MI |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101007662 | MI | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Audiology Distribution, LLC | Past | Accepting new patients |
Interoperability endpoints
- markiewicz@yourcarecommunity.org
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458432000000",
"number": "1851359178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 S 3RD ST",
"address_2": "STE 200",
"city": "CARSON CITY",
"state": "MI",
"postal_code": "488115115",
"telephone_number": "989-584-0932",
"fax_number": "989-584-0918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 S 3RD ST",
"address_2": "STE 200",
"city": "CARSON CITY",
"state": "MI",
"postal_code": "488115115",
"telephone_number": "989-584-0932",
"fax_number": "989-584-0918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKIEWICZ",
"first_name": "KENNETH",
"middle_name": "HARRY",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2016-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "MI",
"license": "5101007662",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "0454111024",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1642877",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carson City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.