KENNETH KACENGA (NPI# 1245279827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245279827 |
| Entity Type | Individual |
| Full Name | KENNETH KACENGA |
| Credential | DO |
| Practice Address |
155 Colle Portal 300 Sierra Vista AZ 85635 |
| Practice Telephone | 5204588075 |
| Practice Fax Number | 5204580339 |
| Mailing Telephone | 5204588075 |
| Mailing Fax Number | 5204580339 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2008-01-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 01607 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AETNA | 4114160 | 01 | |
| AZ | 241997 | 05 | |
| BCBS AZ | AZ0779520 | 01 |
| Street Address |
155 COLLE PORTAL 300 |
| City | SIERRA VISTA |
| State | AZ |
| Zip Code | 85635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134740640 | Taylor Anne Phelps | Student in an Organized Health Care Education/Training Program | Haven of Sierra Vista LLC, 660 Coronado Drive, Sierra Vista, AZ 85635 | 2020-05-06 |
| 1568001543 | Gp Medicine, Pllc | Family Medicine | 1800 E Wilcox Drive, Sierra Vista, AZ 85635 | 2019-12-23 |
| 1518515212 | Canyon Vista Dental | Dentist | 1993 S Frontage Road, Suite 208, Sierra Vista, AZ 85635 | 2019-08-27 |
| 1225697402 | Kristine Vincent Cruz Angeles | Dentist | 115 Calle Poral, Sierra Vista, AZ 85635 | 2019-06-11 |
| 1700397411 | Vivian Ryu | Social Worker | 2300 E Fry Blvd, #3822, Sierra Vista, AZ 85635 | 2017-10-20 |
| 1750806758 | Rosemary Nduta Kagwanja | Technician | 425 Bernini Avenue, N/a, Sierra Vista, AZ 85635 | 2017-08-10 |
| 1093245789 | Akdhc, LLC | Internal Medicine | 5555 Mesa Verde Dr, Suite 100, Sierra Vista, AZ 85635 | 2017-06-14 |
| 1609304633 | Vincent Guarino | Emergency Medicine | 5700 E, Az-90, Sierra Vista, AZ 85635 | 2017-06-04 |
| 1629506811 | Andrew Tang | Student in an Organized Health Care Education/Training Program | 5700 Arizona 90, Sierra Vista, AZ 85635 | 2017-06-01 |
| 1194259382 | Walik Hargett | Contractor | 800 N. Lenzner Ave Apt 776b, Sierra Vista, AZ 85635 | 2017-04-14 |
| Find all providers in zip 85635 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104184522 | Bella Sierra Womens Center Pllc | Obstetrics & Gynecology | 3410 Canyon De Flores Ste C, Sierra Vista, AZ 85650-5373 | 2012-04-24 |
| 1932120870 | Bruce E Silva Md and Kenneth S. Kacenga Do Pllc | Obstetrics & Gynecology | 155 Calle Portal Ste 300, Sierra Vista, AZ 85635-2900 | 2006-07-23 |
| 1861426439 | Robert B Holder | Obstetrics & Gynecology | 174 S Coronado Dr, Suite A, Sierra Vista, AZ 85635-2860 | 2006-07-10 |
| 1801836119 | Bruce E Silva | Obstetrics & Gynecology | 174 S Coronado Dr Ste A, Sierra Vista, AZ 85635-6356 | 2006-06-07 |
| 1720218860 | Sierra Vista Obstetrics & Gynecology Inc | Obstetrics & Gynecology | 75 Colonia De Salud, Ste 100b, Sierra Vista, AZ 85635-2487 | 2009-07-23 |
| 1104054378 | Nathaniel D. Evans | Obstetrics & Gynecology | 5750 E. Highway 90, Suite 300a, Sierra Vista, AZ 85635 | 2009-06-26 |
| 1669656609 | Robert B Holder, LLC | Obstetrics & Gynecology | 174 S Coronado Dr, Suite A, Sierra Vista, AZ 85635 | 2007-12-27 |
| 1518141555 | Robert B Holder LLC | Obstetrics & Gynecology | 174 S Coronado Dr, Suite A, Sierra Vista, AZ 85635-8584 | 2007-12-27 |
| 1851312896 | James A Griggs Cochise Womens Care Pllc | Obstetrics & Gynecology | 75 Colonia De Salud Ste 200c, Sierra Vista, AZ 85635-2486 | 2006-07-23 |
| 1033140512 | Cynthia G. Funckes | Obstetrics & Gynecology | 5750 E. Highway 90, Ste. 300 A & B, Sierra Vista, AZ 85635 | 2006-07-05 |
| Find all providers in SIERRA VISTA | ||||
| City | SIERRA VISTA |
| Zip Code | 85635 |
Please comment or provide details below to improve the information on KENNETH KACENGA.
| 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.