KENNETH LEROY KING SR. (NPI# 1568086346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568086346 |
| Entity Type | Individual |
| Full Name | KENNETH LEROY KING SR. |
| Practice Address |
1900 Silver Lake Rd Nw New Brighton MN 55112-1786 |
| Practice Telephone | 6516289566 |
| Mailing Telephone | 6516289566 |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2020-06-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376751636 | Kenneth D King | Massage Therapist | 2024 54th Ave E, Suite A, Fife, WA 98424-1901 | 2007-05-18 |
| 1447466842 | Kenneth Joe King | Dentist | 2815 Eastex Fwy, Houston, TX 77026-6009 | 2007-05-15 |
| 1811027329 | Kenneth R King | Psychiatry & Neurology | 15600 Redmond Way Ste 201, Redmond, WA 98052-3862 | 2007-03-06 |
| 1164587796 | Kenneth Arthur King | Dentist | 10920 River Front Pkwy, Roseman University of Health Sciences, Codm, South Jordan, UT 84095-3538 | 2006-12-26 |
| 1750469680 | Kenneth Brian King | Optometrist | 4501 Heritage Trace Pkwy Ste 121, Fort Worth, TX 76244 | 2006-11-01 |
| 1568434843 | Kenneth B King | Internal Medicine | 500 George Mcclain Drive, Benton, KY 42025 | 2006-02-02 |
| 1174524722 | Kenneth William King Jr. | Optometrist | 1480 E Lincoln Rd, Idaho Falls, ID 83401-2128 | 2005-08-04 |
| 1942206651 | Kenneth Raymond King | Allergy & Immunology | 2101 Executive Dr, Tower Box 56, Hampton, VA 23666-2404 | 2005-06-27 |
| 1548738941 | Kenneth King | Physical Therapist | 5 Pequot Park Rd Ste 102, Westbrook, CT 06498-2856 | 2018-11-05 |
| 1386177327 | Kenneth Ron King | Podiatrist | 13030 121st Way Ne Ste 204, Kirkland, WA 98034-3008 | 2017-04-06 |
| Street Address |
1900 SILVER LAKE RD NW |
| City | NEW BRIGHTON |
| State | MN |
| Zip Code | 55112-1786 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861492134 | Edwin Walker | Psychiatry & Neurology | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2005-07-28 |
| 1144833484 | Anna Marie Ricci | Counselor | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2020-08-26 |
| 1184247108 | Alissa Marie Lambrides | Counselor | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2020-05-26 |
| 1184247660 | Tammie Leetta Fullman | Counselor | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2020-05-19 |
| 1396379541 | Meredith Lawlor | Counselor | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2020-02-26 |
| 1154961225 | Ryan Jones | Counselor | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2020-01-07 |
| 1902440944 | Olufemi Michael Adetunji | Nurse Practitioner | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2019-11-02 |
| 1174166672 | Williametta Augusta Wells | Counselor | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2019-10-28 |
| 1780227736 | Jason T Caspillo | Psychologist | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2019-10-22 |
| 1043866163 | Amanda Louise Wegner | Counselor | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2019-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932729704 | Owegio Wreh | Technician | 1405 Silver Lake Road Suite 15, New Brighton, MN 55112 | 2020-04-22 |
| 1205497435 | Silver Lake Smiles Family Dentistry | Clinic/Center | 2370 Palmer Drive, New Brighton, MN 55112 | 2019-06-27 |
| 1932766169 | Matthew Thomas Hanowski | Dentist | 2442 Mounds View Boulevard, Mounds View, MN 55112 | 2019-05-22 |
| 1437619988 | Marjean Diane Leary | Registered Nurse | 338 New Brighton Road, Apt, Suite, Bldg. (optional), New Brighton, MN 55112 | 2019-03-21 |
| 1558802728 | Krishna Katira | Student in an Organized Health Care Education/Training Program | 2442 County Hwy 10, Mounds View, MN 55112 | 2017-03-20 |
| 1245781608 | Evan Fredrick Lieberman | Counselor | 1900 Silver Lake Rd, Suite 110, New Brighton, MN 55112 | 2016-10-20 |
| 1093262065 | Ryan Zinken | Nurse Practitioner | 1900 Silver Lake Road, Suite 110, New Brighton, MN 55112 | 2016-09-07 |
| 1447703228 | Alison Glodek | Social Worker | 2543 17th St Nw, New Brighton, MN 55112 | 2016-07-28 |
| 1659728194 | Ge Vang Sr. | Driver | 2160 County Road E West #205, 2160 County Road E West #205, New Brighton, MN 55112 | 2016-05-14 |
| 1114373578 | Jessica Gapinski | Specialist/Technologist | 3900 Bethel Drive, Arden Hills, MN 55112 | 2016-05-04 |
| Find all providers in zip 55112 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942815980 | Miranda Marie Lacroix | Student in an Organized Health Care Education/Training Program | 1204 Black Oak Dr, New Brighton, MN 55112-8432 | 2020-09-15 |
| 1215315544 | Julie Ljung | Student in an Organized Health Care Education/Training Program | 2075 Mississippi Cir, New Brighton, MN 55112-5100 | 2015-05-06 |
| 1154722825 | Aidan Kao | Student in an Organized Health Care Education/Training Program | 1001 6th St Sw, New Brighton, MN 55112-7656 | 2014-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154921047 | Liesa Clare Erickson | Student in an Organized Health Care Education/Training Program | 100 Elizabeth St Apt 416, Duluth, MN 55803-2643 | 2020-10-29 |
| 1639779804 | Chelsie Meemken | Student in an Organized Health Care Education/Training Program | 505 Bluebird Ct, Sartell, MN 56377-1633 | 2020-10-27 |
| 1134729486 | Anna R Spiczka | Student in an Organized Health Care Education/Training Program | 10689 108th Ave N, Hanover, MN 55341-4124 | 2020-10-27 |
| 1558961003 | Maren Elizabeth Iverson | Student in an Organized Health Care Education/Training Program | 1 Veterans Dr # 160, Minneapolis, MN 55417-2309 | 2020-10-26 |
| 1275132003 | Faizo A Hersi | Student in an Organized Health Care Education/Training Program | 9700 International Dr Suite 300, Bloomington, MN 55425 | 2020-10-22 |
| 1467059048 | Ashli Willow Boehm | Student in an Organized Health Care Education/Training Program | 1920 Turning Leaf Ln Sw, Alexandria, MN 56308-4662 | 2020-10-06 |
| 1174130421 | Carolyne Copley | Student in an Organized Health Care Education/Training Program | 226 2nd St Sw, Rochester, MN 55905-0001 | 2020-09-29 |
| 1023624483 | Katherine Hailey Lake | Student in an Organized Health Care Education/Training Program | 16415 Temple Dr, Minnetonka, MN 55345-3431 | 2020-09-21 |
| 1235745027 | Andrew Ryan Mcnamara | Student in an Organized Health Care Education/Training Program | 1015 Lowry Ave Ne Apt 3, Minneapolis, MN 55418-3727 | 2020-09-17 |
| 1740895770 | Arielle Johnson | Student in an Organized Health Care Education/Training Program | 1162 Thomas Ave, Saint Paul, MN 55104-2538 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
| City | NEW BRIGHTON |
| Zip Code | 55112 |
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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.