1134398365 NPI number — KENNETH S ALLISON JR. M.D.

Table of content: KENNETH S ALLISON JR. M.D. (NPI 1134398365)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134398365 NPI number — KENNETH S ALLISON JR. M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALLISON
Provider First Name:
KENNETH
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
JR.
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134398365
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10800 E GEDDES AVE STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ENGLEWOOD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80112-3895
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-761-9190
Provider Business Mailing Address Fax Number:
720-874-4462

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10800 E GEDDES AVE STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ENGLEWOOD
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80112-3895
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-761-9190
Provider Business Practice Location Address Fax Number:
720-874-4462
Provider Enumeration Date:
02/21/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  234771 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 53456 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 27766 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 04-37111 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 54275 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: R1162 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: MD15618 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 74531735 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100262773-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100262778-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 840897126-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1134398365 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100257090-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100262774-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1134398365 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 840597929-13 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00H0292923 . This is a "HMSA HAWAII" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 00H0292923 . This is a "HMSA ALL PRODUCTS" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 1134398365 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1134398365 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 201096030A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100262776-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 911135 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".




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