DR. KENNY K. CHARN (NPI# 1083715254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083715254 |
| Entity Type | Individual |
| Full Name | DR. KENNY K. CHARN |
| Credential | M.D. |
| Practice Address |
201 Clinton Rd Suite 105 Jackson CA 95642-2648 |
| Mailing Address |
Po Box 5406 El Dorado Hills CA 95762-0008 |
| Practice Telephone | 2092231194 |
| Practice Fax Number | 2092231196 |
| Mailing Telephone | 2092231194 |
| Mailing Fax Number | 2092231196 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2008-06-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
G68975 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
201 CLINTON RD SUITE 105 |
| City | JACKSON |
| State | CA |
| Zip Code | 95642-2648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336219930 | Donald Duane Vanfossan | Psychiatry & Neurology | 201 Clinton Rd, Suite 106, Jackson, CA 95642-2648 | 2006-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932666575 | Gold Country Health Initiative, LLC | Family Medicine | 820/830 State Highway 88, Jackson, CA 95642 | 2019-03-01 |
| 1053844902 | Kathryn Erosa | Pharmacist | 515 Highway 49 South, Jackson, CA 95642 | 2017-04-07 |
| 1356882039 | Thomas Alan Bowhay | Clinic/Center | 820 Highway 88, Jackson, CA 95642 | 2017-03-15 |
| 1710130141 | Roland E Womack | Dentist | 511 Sutter St, Jackson, CA 95642 | 2008-10-29 |
| 1508929522 | Stanley M Ordonez | Dentist | 645 New York Ranch Rd, Jackson, CA 95642 | 2006-12-19 |
| 1942374996 | Thomas W Zeiler | Chiropractor | 665 New York Ranch Rd Suite 2, Jackson, CA 95642 | 2006-11-20 |
| 1023188968 | Cordelia Rose Slayter | Physical Therapist | 711 S State Hwy 49, Jackson, CA 95642 | 2006-11-08 |
| 1285744946 | Raleys | Pharmacy | 781 South Highway 49, Jackson, CA 95642 | 2006-08-30 |
| 1316996747 | Robert R. Bussell X | Physical Therapist | 813 Court Street, Ste 2, Jackon, CA 95642 | 2006-05-10 |
| 1861953135 | Chelsea Yule Solutions | Clinic/Center | 230 N Main St, Jackson, CA 95642 | 2019-03-28 |
| Find all providers in zip 95642 | ||||
| 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 |
|---|---|---|---|---|
| 1053935437 | Cvc Pllc | Internal Medicine | 22 Deepwood Dr, Jackson, TN 38305-9679 | 2020-06-02 |
| 1912143991 | Theophilus James Humphreys | Internal Medicine | 164 W University Pkwy Ste A, Jackson, TN 38305-1621 | 2008-12-23 |
| 1548423114 | Olurotimi Badero | Internal Medicine | 5240 Robinson Rd, Jackson, MS 39204-4134 | 2008-07-03 |
| 1740480961 | Cardiovascular Clinic of West Tn PC | Internal Medicine | 2968 North Highland Avenue, Jackson, TN 38305-3609 | 2007-07-25 |
| 1013112457 | The Cardiovascular Clinic of West Tennessee,p.c. | Internal Medicine | 162 Murray Guard Dr, Suite A, Jackson, TN 38305-3609 | 2007-06-17 |
| 1497829550 | Shawn A Baldwin | Internal Medicine | 27a Medical Center Dr, Jackson, TN 38301-3949 | 2006-11-20 |
| 1861590457 | Sandra Speckels Mccearley | Internal Medicine | 970 Lakeland Dr Ste 61, Jackson, MS 39216 | 2006-09-20 |
| 1063425734 | Mabbu Jayakumar | Internal Medicine | 168 W University Pkwy Ste C, Jackson, TN 38305-1624 | 2006-08-14 |
| 1851305429 | Jackson Cardiology Associates, P.a. | Internal Medicine | 971 Lakeland Dr Ste 850, Jackson, MS 39216-4608 | 2006-07-28 |
| 1518989003 | Hinds Cardiology Clinic Pa | Internal Medicine | 1832 Hospital Drive, Jackson, MS 39204-3410 | 2006-07-24 |
| Find all providers in JACKSON | ||||
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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.