Active NPI
Kenneth Eugene Harper, MD
- Diagnostic Radiology Physician
- Edmond, OK
National Provider Identifier
1972551455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 11552
- Practice address
- 1705 Renaissance Blvd
Suite 150
Edmond, OK 73013-3041 - Phone
- (405) 285-6901
- Fax
- (405) 285-6902
- NPI assigned
- May 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 11552 | OK | Primary |
Addresses
Primary practice location
1705 Renaissance Blvd
Suite 150
Edmond, OK 73013-3041
Mailing address
1705 Renaissance Blvd
Suite 150
Edmond, OK 73013-3041
Phone (405) 285-6901
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100082870A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11552 | OK | MD | Pharmacotherapy Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Renaissance Medical Management LLC | Diagnostic Radiology | Past | Accepting new patients |
| Radiology Consultants, PC | Diagnostic Radiology | Past | Accepting new patients |
| Foundation Radiology Group PC | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Diagnostic Radiology Physician
- Edmond, OK
- NPI 1962485524
-
- Diagnostic Radiology Physician
- Oklahoma City, OK
- NPI 1528000288
-
- Diagnostic Radiology Physician
- Edmond, OK
- NPI 1194583963
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342483200000",
"number": "1972551455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1705 RENAISSANCE BLVD",
"address_2": "SUITE 150",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133041",
"telephone_number": "405-285-6901",
"fax_number": "405-285-6902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 RENAISSANCE BLVD",
"address_2": "SUITE 150",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133041",
"telephone_number": "405-285-6901",
"fax_number": "405-285-6902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARPER",
"first_name": "KENNETH",
"middle_name": "EUGENE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2012-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OK",
"license": "11552",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100082870A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.