DR. KENNETH JAMES RATAJCZAK (NPI# 1063418929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063418929 |
| Entity Type | Individual |
| Full Name | DR. KENNETH JAMES RATAJCZAK |
| Credential | M.D. |
| Practice Address |
3724 Greenleaf Drive Waco TX 76710-1414 |
| Mailing Address |
3724 Greenleaf Dr Waco TX 76710-1414 |
| Practice Telephone | 2547764804 |
| Mailing Telephone | 2547764804 |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2017-08-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
H1651 | TX | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | H1561 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | RAILROAD MEDICARE PROV NO | P00124090 | 01 |
| TX | 134236209 | 05 | |
| TX | AETNA PROVIDER NUMBER | 5698031 | 01 |
| TX | 134236208 | 05 | |
| TX | BCBS PROVIDER NUMBER | 8K6251 | 01 |
| Street Address |
3724 GREENLEAF DRIVE |
| City | WACO |
| State | TX |
| Zip Code | 76710-1414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740741156 | Jessica Cook-lindsay | Physical Therapist | 2121 W Hwy 6, Waco, Waco, TX 76710 | 2019-03-28 |
| 1306354824 | Paula A Huffhines | Technician, Other | 115 S 25th, Waco, TX 76710 | 2018-01-18 |
| 1982154639 | Nha Do | Pharmacist | 1301 Wood Acres, Waco, TX 76710 | 2016-10-06 |
| 1649662495 | Pediatric Advanced Life Services Home Health LLC | Home Health | 3640 W Waco Dr, Waco, TX 76710 | 2015-03-02 |
| 1881008795 | Soumava Sen, Dds, P.C. | Dentist | 4215 Franklin Ave, Ste. 300, Waco, TX 76710 | 2014-06-18 |
| 1053742221 | Dustin Dwain Kelm | Physical Therapist | 5400 Laurel Dr., Waco, TX 76710 | 2013-12-12 |
| 1881038776 | Penelope Diane Lane | Counselor | 7524 Bosque, Waco, TX 76710 | 2013-04-22 |
| 1538400627 | Erik Alexander Pernes Caluscusao | Physical Therapist | 415 Owen Ln Apt 911, Waco, TX 76710 | 2013-03-14 |
| 1447509039 | Sheree L Mach | Occupational Therapist | 5400 Laurel Lake Dr., Waco, TX 76710 | 2012-08-29 |
| 1568738425 | Ramanathan Anandaraman | Internal Medicine | 2608 Skyline Drive, Waco, TX 76710 | 2012-03-26 |
| Find all providers in zip 76710 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831100023 | William P. Coleman | General Practice | 504 Meadowlake Center, Waco, TX 76712-3981 | 2006-08-11 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.