Kenneth P. Tway, M.D., F.a.C.C., Inc.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

G39106 Issued in CA

Legal business name

KENNETH P. TWAY, M.D., F.A.C.C., INC.

Practice address

1106 Pacific St
San Luis Obispo, CA 93401-3302

Phone

(805) 546-9500

Fax

(805) 546-9699

NPI assigned

Dec 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Paul Tway, M.D.NPI 1396924189

Title

President

Phone

(805) 546-9500

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13554/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth P Tway

  • Cardiovascular Disease Physician
  • San Luis Obispo, CA
  • NPI 1396924189
  Medicare reassignment NPD Authorized official
• Laura Christina Fundingsland, PA-C

  • Physician Assistant
  • San Luis Obispo, CA
  • NPI 1871057141
  Medicare reassignment

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1902961444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 PACIFIC ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013302",
            "telephone_number": "805-546-9500",
            "fax_number": "805-546-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 PACIFIC ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013302",
            "telephone_number": "805-546-9500",
            "fax_number": "805-546-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH P. TWAY, M.D., F.A.C.C., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "TWAY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-546-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G39106",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "G39105",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G391050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Kennard, AU.D.
• Amaia Sophia Kennedy
• Ezery Kennedy Jr.
• Timothy Kennedy
• Kenneth L Baldwin M D Inc
• Dara Lynn Kerkorian, MSW
• Valerie Ann Marie Kert
• Grace Elisabeth Kessler I
• Penny Ketchum
• Cheryl Ketelsen

• Cardiovascular Disease Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.