DR. KENNETH E MCINTYRE (NPI# 1740268556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740268556 |
| Entity Type | Individual |
| Full Name | DR. KENNETH E MCINTYRE |
| Credential | M.D. |
| Practice Address |
1707 W Charleston Blvd #160, Patient Care Center Las Vegas NV 89102-2351 |
| Mailing Address |
2040 W Charleston Blvd #601 Las Vegas NV 89102-2227 |
| Practice Telephone | 7026715150 |
| Practice Fax Number | 7026846493 |
| Mailing Telephone | 7026712274 |
| Mailing Fax Number | 7023847506 |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2012-12-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
10314 | NV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 002018582 | 05 | |
| NV | PHARMACY/CDS | CS11417 | 01 |
| NV | DEA | AM6894427 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033120308 | Kenneth Mark Mcintyre | Internal Medicine | 1725 W Monroe St, Wytheville, VA 24382 | 2006-08-11 |
| Street Address |
1707 W CHARLESTON BLVD #160, PATIENT CARE CENTER |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89102-2351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750377693 | Miracle Wangsuwana | Psychiatry & Neurology | 1707 W Charleston Blvd, Suite #220, Las Vegas, NV 89102-2351 | 2005-09-26 |
| 1073040127 | Evan Drew Davis | Student in an Organized Health Care Education/Training Program | 1707 W Charleston Blvd, Las Vegas, NV 89102-2351 | 2017-05-19 |
| 1336674969 | Bobby Karandeep Singh Brar | Student in an Organized Health Care Education/Training Program | 1707 W Charleston Blvd, Suite 120, Las Vegas, NV 89102-2351 | 2017-04-20 |
| 1497280036 | Pooja Patil | Student in an Organized Health Care Education/Training Program | 1707 W Charleston Blvd, Suite 120, Las Vegas, NV 89102-2351 | 2017-04-20 |
| 1346772597 | Angela Hui-chia Liu | Student in an Organized Health Care Education/Training Program | 1707 W Charleston Blvd, Suite 120, Las Vegas, NV 89102-2351 | 2017-03-28 |
| 1902345077 | Ankita Raman | Student in an Organized Health Care Education/Training Program | 1707 W Charleston Blvd, Ste 120, Las Vegas, NV 89102-2351 | 2017-02-22 |
| 1669852513 | Cameron Lasley | Student in an Organized Health Care Education/Training Program | 1707 W Charleston Blvd, Suite 290, Las Vegas, NV 89102-2351 | 2015-06-05 |
| 1043627508 | Richard Witty Jr. | Dentist | 1707 W Charleston Blvd, Suite 290, Las Vegas, NV 89102-2351 | 2014-07-16 |
| 1346657285 | Jacqueline Sanders Delaney | Dentist | 1707 W Charleston Blvd, Suite 290, Las Vegas, NV 89102-2351 | 2014-07-11 |
| 1710305156 | Ali Osama Malik | Internal Medicine | 1707 W Charleston Blvd, Las Vegas, NV 89102-2351 | 2014-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851998397 | Natasha Moore | Technician | 3210 W Charleston Suite 2, Las Vegas, NV 89102 | 2020-10-07 |
| 1568077113 | Zulma Yaneth Tervizo Lopez | Technician | 455 W Oakey Blvd, Ste 111, Las Vegas, NV 89102 | 2020-09-10 |
| 1922629765 | Bianca Vaudreuil | Religious Nonmedical Practitioner | 3210 W Charleston Ste 2, Las Vegas, NV 89102 | 2020-05-04 |
| 1720608052 | Angelica Gutierrez | Technician | Vegas Compassionate Care ; 2820 W. Charleston Blvd B-21, Las Vegas, NV 89102 | 2020-04-16 |
| 1396370680 | Juana Maria Hernandez | Technician | 2881 S. Valley View Blvd, Suite #6, Las Vegas, NV 89102 | 2020-03-06 |
| 1609409648 | Janie Washington | Technician | 3210 W Charleston Blvd. Suite 2, Las Vegas, NV 89102 | 2020-02-18 |
| 1447893185 | Maria Josefina Castaneda | Technician | 2881 S. Valley View Blvd Suite #6, Los Vegas, NV 89102 | 2019-10-25 |
| 1427608777 | Virginia Hernandez Tolentino | Technician | 4550 W Oakley Blvd, Suite 101 A, Las Vegas, NV 89102 | 2019-09-18 |
| 1972153872 | Gladiola Cardoza Quinones | Technician | 2881 S. Valley View Blvd #6, Las Vegas, NV 89102 | 2019-09-13 |
| 1801445572 | Rafael Roberto Gonzalez Palomino | Homemaker | 4550 W. Oakey Blvd, Suite 111-0, Las Vegas, NV 89102 | 2019-09-05 |
| Find all providers in zip 89102 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891254439 | Valley Vascular Khan PC | Surgery | 5785 S Fort Apache Rd Ste B, Las Vegas, NV 89148-5629 | 2019-03-13 |
| 1710158001 | Eugene G. Porreca, Md., LLP | Surgery | 2655 Box Canyon Dr, #110, Las Vegas, NV 89128-1119 | 2008-03-14 |
| 1184849259 | Matthew Cooper Md Ltd | Surgery | 7375 Peak Dr Ste 110, Las Vegas, NV 89128-9030 | 2007-04-16 |
| 1194804211 | Earl David Cottrell | Surgery | 7200 W Cathedral Rock Dr Ste #130, Las Vegas, NV 89128 | 2006-11-02 |
| 1104913656 | Frank Thomas Jordan | Surgery | 7200 W Cathedral Rock Dr, Ste #130, Las Vegas, NV 89128 | 2006-10-06 |
| 1083624688 | Desert Cardiovascular Surgery | Surgery | 2110 E Flamingo Rd Ste 205, Las Vegas, NV 89119-5192 | 2006-08-08 |
| 1104834639 | John Marshall Ham | Surgery | 1120 Shadow Ln, Suite D-100, Las Vegas, NV 89102-2342 | 2006-08-03 |
| 1265831432 | Nkdhc Rudnitsky Pllc | Surgery | 2545 S Bruce St Ste 200, Las Vegas, NV 89169-1778 | 2014-08-14 |
| 1740455229 | Hazem Y Afifi | Surgery | 5380 S Rainbow Blvd Ste 110, Las Vegas, NV 89118-1878 | 2008-04-25 |
| 1023299500 | Chino Md Ltd | Surgery | 3150 N Tenaya Way, Ste 560, Las Vegas, NV 89128-0443 | 2007-11-26 |
| Find all providers in LAS VEGAS | ||||
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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.