Active NPI
Kenneth J Capone, M.D.
- Pediatrics Physician
- Mandeville, LA
National Provider Identifier
1871504290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 014719
- Practice address
- 201 Saint Ann Dr
Suite B
Mandeville, LA 70471-3219 - Phone
- (985) 626-1717
- NPI assigned
- Aug 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 014719 | LA | Primary |
Addresses
Primary practice location
201 Saint Ann Dr
Suite B
Mandeville, LA 70471-3219
Mailing address
201 Saint Ann Dr
Suite B
Mandeville, LA 70471-3219
Phone (985) 626-1717
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1312151 | Medicaid | LA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014719 | LA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301616000000",
"number": "1871504290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 SAINT ANN DR",
"address_2": "SUITE B",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704713219",
"telephone_number": "985-626-1717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 SAINT ANN DR",
"address_2": "SUITE B",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704713219",
"telephone_number": "985-626-1717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAPONE",
"first_name": "KENNETH",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-10",
"last_updated": "2011-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "LA",
"license": "014719",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1312151",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mandeville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.