MICHAEL D KENNER, MD,PC (NPI# 1184824617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184824617 |
| Entity Type | Organization |
| Organization Name | MICHAEL D KENNER, MD,PC |
| Other Organization Name | NONE |
| Practice Address |
1721 S 10th Ave Caldwell ID 83605-4839 |
| Practice Telephone | 2084531062 |
| Practice Fax Number | 2084531196 |
| Mailing Telephone | 2084531062 |
| Mailing Fax Number | 2084531196 |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2007-07-23 |
| Authorized Official Name | DR. MICHAEL DAVID KENNER (DOCTOR/OWNER) |
| Authorized Official Telephone | 2084531062 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| none | Other Name - Individual/Organization |
| Street Address |
1721 S 10TH AVE |
| City | CALDWELL |
| State | ID |
| Zip Code | 83605-4839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585660 | Laurie Bernstein | Occupational Therapist | 2205 Sunset Avenue, Caldwell, ID 83605 | 2020-07-06 |
| 1881249316 | Elevate Academy | Local Education Agency (LEA) | 114 W. Chicago St., Caldwell, ID 83605 | 2019-08-01 |
| 1669025359 | James Smith | Pharmacist | 2809 E Caldwell Blvd, Caldwell, ID 83605 | 2019-07-22 |
| 1164910824 | Michelle Stoddard | Physician Assistant | 315 E Elm St Ste 200, Caldwell, ID 83605 | 2018-04-27 |
| 1215430483 | Amy E Rudolf | Pharmacist | 315 E Elm St Ste 150, Caldwell, ID 83605 | 2018-03-14 |
| 1871044883 | Kool Ridez LLC | Case Management | 1803 Ellis Ave., Caldwell, ID 83605 | 2016-10-14 |
| 1932550795 | Chris Torgerson | Social Worker | 3402 Franklin Blvd, Caldwell, ID 83605 | 2016-06-23 |
| 1609237742 | Peggy A Mcfarland | Counselor | 534 Cleveland Suite 230, Caldwell, ID 83605 | 2016-03-17 |
| 1720468101 | Devin Douglas Dredge | Emergency Medicine | 1717 Arlington Ave Dept Of, Caldwell, ID 83605 | 2015-06-01 |
| 1578950168 | Trinidad Bridge | Licensed Practical Nurse | 2909 S. 10th Avenue, Caldwell, ID 83605 | 2015-04-21 |
| Find all providers in zip 83605 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275647174 | Michael Sidney Horowitz | Internal Medicine | 112 Bloomfield Ave, Caldwell, NJ 07006-5336 | 2006-08-18 |
| 1265486625 | Murali N Bathina | Internal Medicine | 315 E Elm Street, Ste 350, Caldwell, ID 83605 | 2006-05-20 |
| 1770873572 | St Lukes Idaho Cardiology Associates | Internal Medicine | 315 E Elm St, Suite 350, Caldwell, ID 83605-4857 | 2011-04-13 |
| 1255386942 | James C Field | Internal Medicine | 315 E Elm St, Ste 350, Caldwell, ID 83605 | 2006-05-23 |
| 1013969377 | Giovanni Campanile | Internal Medicine | 14 Smull Ave, Caldwell, NJ 07006-5012 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1801336276 | Bmh, Inc. | Internal Medicine | 235 Poplar St, Blackfoot, ID 83221 | 2017-03-03 |
| 1811201312 | Providence Health & Services | Internal Medicine | 715 S Washington, Suite A, Moscow, ID 83843-0000 | 2010-07-27 |
| 1730323080 | Wayne Wright | Internal Medicine | 2664 E 3700 N, Twin Falls, ID 83301-0145 | 2009-04-29 |
| 1497807812 | Grande Ronde Hospital, Inc | Internal Medicine | 300 E Jefferson St Ste 101, Boise, ID 83712-6221 | 2007-01-17 |
| 1700983137 | Lee Walter Gould | Internal Medicine | 307 St. John's Way, Suite 114, Lewiston, ID 83501-2456 | 2006-09-20 |
| 1730285719 | Beth R Malasky | Internal Medicine | 6140 Curtisian, Ste 200, Boise, ID 83704-0107 | 2006-09-16 |
| 1730192329 | Cardiovascular Consultants of Idaho | Internal Medicine | 1070 N Curtis Rd, Ste 125, Boise, ID 83706-1238 | 2006-08-14 |
| 1477578300 | John E Lassetter | Internal Medicine | 2001 S Woodruff Ave Ste 3, Idaho Falls, ID 83404 | 2006-07-13 |
| 1841234747 | Samual Bass | Internal Medicine | 300 E Jefferson, Ste 101, Boise, ID 83712 | 2006-06-15 |
| 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.