NPIMap

Individual provider Active NPI

Kenadey Rose Dahlenburg, PA-C

  • Physician Assistant
  • Hinton, OK
National Provider Identifier
1881358414
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
112 E Luellen Rd
Hinton, OK 73047-9524
Phone
(833) 274-4174
Fax
(833) 274-4178
NPI assigned
Oct 29, 2021
Last updated
Jun 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

112 E Luellen Rd
Hinton, OK 73047-9524

Mailing address

12095 County Road 1060
Hinton, OK 73047-9554
Phone (405) 368-7831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211230000187 OK Practitioner - Physician Assistant 0941691919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Physicians Group, LLCGroup PAC ID 8325950603, 107 clinicians

Practice addresses (Care Compare)

10021 S Western Ave
Oklahoma City, OK 73139-2927
Phone (405) 692-9300

112 E Luellen Rd
Hinton, OK 73047-9524
Phone (833) 274-4174

1616 S Kelly Ave
Edmond, OK 73013-3651
Phone (405) 330-0032

4400 Grant Blvd
Yukon, OK 73099-0037
Phone (405) 787-8550

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kdahlenburg534986@direct.integrisok.com
  • Direct secure messaging: kenadeydahlenburg@okss.allscriptsdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1635465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1881358414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12095 COUNTY ROAD 1060",
            "city": "HINTON",
            "state": "OK",
            "postal_code": "730479554",
            "telephone_number": "405-368-7831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E LUELLEN RD",
            "city": "HINTON",
            "state": "OK",
            "postal_code": "730479524",
            "telephone_number": "833-274-4174",
            "fax_number": "833-274-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLENBURG",
        "first_name": "KENADEY",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-29",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinton, OK

Sources for this page

Verify at the official NPI Registry.