NPIMap

Individual provider Active NPI

Kenneth Gayle Lawlor, DO

  • Rheumatology Physician
  • Prescott, AZ
National Provider Identifier
1902917289
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
5487 Issued in AZ
Practice address
3111 Clearwater Dr Ste a
Prescott, AZ 86305-7186
Phone
(480) 443-8400
Fax
(480) 443-8697
NPI assigned
Aug 31, 2006
Last updated
Apr 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 5487 AZ Primary
Rheumatology Physician 207RR0500X 2007015085 MO

Addresses

Primary practice location

3111 Clearwater Dr Ste a
Prescott, AZ 86305-7186

Mailing address

4550 E Bell Rd
Suite 172
Phoenix, AZ 85032-9306
Phone (480) 443-8400

Other identifiers 2

IdentifierTypeStateIssuer
1801100250OtherAZGROUP NATIONAL PROVIDER IDENTIFIER
546714MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20101202000114 AZ Practitioner - Rheumatology 1456448067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Kansas City College of Medicine and Surgery, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kenneth G. Lawlor, DO, PLLCGroup PAC ID 5395931331, 2 clinicians

Practice addresses (Care Compare)

2060 W Whispering Wind Dr
Suite 264
Phoenix, AZ 85085-2869
Phone (623) 235-6889

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
69.32 of 100Reported as individual
Quality
50.25
Improvement activities
40
Cost
64.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth G. Lawlor, DO, PLLC Rheumatology CurrentSince Oct 15, 2010 Accepting new patients
Kenneth G. Lawlor, DO, PLLC Rheumatology CurrentSince Oct 15, 2010 Accepting new patients

Locations

1355 W White Mountain Blvd
Ste A
Lakeside, AZ 85929
Phone (928) 358-4086

2060 W Whispering Wind Dr
Ste 264
Phoenix, AZ 85085
Phone (623) 235-6889

3108 Clearwater Dr
Ste A
Prescott, AZ 86305
Phone (928) 717-8838

3111 Clearwater Dr
Ste A
Prescott, AZ 86305
Phone (928) 717-8838

Interoperability endpoints

  • Direct secure messaging: kenneth.lawlor.1@30296.direct.athenahealth.com
  • Direct secure messaging: kenneth.lawlor.p1@direct.prescottrheum.nextgenshare.com

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 7

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1902917289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 E BELL RD",
            "address_2": "SUITE 172",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850329306",
            "telephone_number": "480-443-8400",
            "fax_number": "480-443-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 CLEARWATER DR STE A",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057186",
            "telephone_number": "480-443-8400",
            "fax_number": "480-443-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWLOR",
        "first_name": "KENNETH",
        "middle_name": "GAYLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "AZ",
            "license": "5487",
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MO",
            "license": "2007015085",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NATIONAL PROVIDER IDENTIFIER",
            "identifier": "1801100250",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "546714",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.