Kenneth Charles Studyvin, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

DOR5D51 Issued in MO

Practice address

2620 North Westwood
Poplar Bluff, MO 63901-9711

Phone

(573) 727-2567

Fax

(573) 727-2379

NPI assigned

Jun 14, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)
• Texas County Memorial Hospital

  dba TCMH Internal Medicine Associates

  • Multi-Specialty Clinic/Center
  • Houston, MO
  • NPI 1306885587
  NPD (past)
• TH Contracting Services of Missouri

  • Emergency Medicine Physician
  • Poplar Bluff, MO
  • NPI 1174570055
  NPD (past)

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922041342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 NORTH WESTWOOD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639019711",
            "telephone_number": "573-727-2567",
            "fax_number": "573-727-2379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 NORTH WESTWOOD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639019711",
            "telephone_number": "573-727-2567",
            "fax_number": "573-727-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUDYVIN",
        "first_name": "KENNETH",
        "middle_name": "CHARLES",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "DOR5D51",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Dawn Strenfel
• Felicia Strickland
• Bradley J Stuckenschneider, M.D.
• Aurora Marie Stucker
• Lyrra Suszanne Stucker, RN
• Ashley Sullivan
• Super D Drugs Acquisition Co. (Super D Express Rx #8407)
• Kirit D Sutaria, MD
• Madison Rose Sutton
• Rangsan Suvan, MD

• Emergency Medicine Physician in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.