Kenneth S Meyer, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

ME59676 Issued in FL

Practice address

820 Prudential Dr Ste 515
Credentialing Department
Jacksonville, FL 32207-8207

Phone

(904) 396-4886

Fax

(904) 398-0496

NPI assigned

Mar 15, 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546214400000",
    "number": "1891764650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45443",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841450443",
            "telephone_number": "904-202-1032",
            "fax_number": "904-376-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 PRUDENTIAL DR STE 515",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078207",
            "telephone_number": "904-396-4886",
            "fax_number": "904-398-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "KENNETH",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2018-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME59676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "053516800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00265784",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luke Metzker, D.O
• Thomas James Metzner, DO
• Katherine N Meuti, CRNA
• Alice Meyer, PA
• Erin Elisabeth Meyer, RD, LD/N
• Melissa A Meyer, MS, CRC
• Michael Meyer, O.D.
• Paula M Meyer, R.N., L.M.H.C.
• Renee Meyer
• Sean P Meyer, PHD

• Infectious Disease Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Infectious Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2018; 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.