Kenneth Michael Fechner II, MD

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

51202-20 Issued in WI

Practice address

480 Central Ave
Pearl Harbor, HI 96860-4908

Phone

(808) 474-4242

NPI assigned

Jan 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1851361851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 CENTRAL AVE",
            "city": "PEARL HARBOR",
            "state": "HI",
            "postal_code": "968604908",
            "telephone_number": "808-474-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 CENTRAL AVE",
            "city": "PEARL HARBOR",
            "state": "HI",
            "postal_code": "968604908",
            "telephone_number": "808-474-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FECHNER",
        "first_name": "KENNETH",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WI",
            "license": "51202-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann English, RN
• Ireneo Espinosa, RN
• Jackie Denise Evans, RN
• Thomas Jay Evans, PH.D.
• Andre M Fang, DDS
• Webster Kerry Felix, DDS, MA, FAGD
• Roberta Lynn Feltes, RN
• Rebecca A Ferguson, DPT
• Michael David Ferreira, D.M.D.
• Evan Stuart Finlay, DO, MPH, MPP

• Sports Medicine (Family Medicine) Physician in Pearl Harbor, HI
• Providers in Pearl Harbor, HI by specialty
• Sports Medicine (Family Medicine) Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.