DR. KENNETH R HOFSTETTER (NPI# 1891753091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891753091 |
| Entity Type | Individual |
| Full Name | DR. KENNETH R HOFSTETTER |
| Credential | M.D. |
| Practice Address |
11209 N Tatum Blvd Suite # 110 Phoenix AZ 85028-3091 |
| Mailing Address |
Po Box 14687 Scottsdale AZ 85267-4687 |
| Practice Telephone | 6022488002 |
| Practice Fax Number | 6022488399 |
| Mailing Telephone | 4809918100 |
| Mailing Fax Number | 4809221028 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
6321 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS | 244947 | 01 |
| AZ | HEALTHNET | 1Z7049 | 01 |
| AZ | BCBS | AZ0324990 | 01 |
| Street Address |
11209 N TATUM BLVD SUITE # 110 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85028-3091 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124011713 | Thomas W Bauch | Family Medicine | 11209 N Tatum Blvd, 175, Phoenix, AZ 85028-3091 | 2005-08-29 |
| 1750837050 | Jennifer Billiard | Social Worker | 11209 N Tatum Blvd, #260, Phoenix, AZ 85028-6025 | 2016-08-28 |
| 1063861060 | Matthew Wisehart | Physical Therapist | 11209 N Tatum Blvd, Ste B-120, Phoenix, AZ 85028-3091 | 2016-06-09 |
| 1861862989 | Jennifer Anne Billingsley | Nurse Practitioner | 11209 N Tatum Blvd, Suite 255, Phoenix, AZ 85028 | 2015-10-01 |
| 1467876524 | Melisa Ann Curry | Physical Therapist | 11209 N Tatum Blvd, Ste B-120, Phoenix, AZ 85028-3091 | 2014-02-10 |
| 1114267887 | Allison M Gaylor | Nurse Practitioner | 11209 N Tatum Blvd, Suite 180, Phoenix, AZ 85028-3091 | 2013-02-18 |
| 1598011785 | Jessica Lynn Giddings | Nurse Practitioner | 11209 N Tatum Blvd, Suite 260, Phoenix, AZ 85028-3091 | 2012-07-25 |
| 1518119692 | Joanne L Schlesinger | Nurse Practitioner | 11209 N Tatum Blvd, Suite 260, Phoenix, AZ 85028-3091 | 2008-10-21 |
| 1295984987 | Sonya A Bladow | Chiropractor | 11209 N Tatum Blvd, Ste 140, Phoenix, AZ 85028-3091 | 2008-09-17 |
| 1114182888 | Rakesh Kumar Bagai | Internal Medicine | 11209 N Tatum Blvd, #260, Phoenix, AZ 85028-3091 | 2008-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235626565 | Celice Korsten | Psychologist | 11020 N. Tatum Blvd., Ste. 100, Phoenix, AZ 85028 | 2018-04-23 |
| 1720591605 | Michele Kaplan | Counselor | 11640 N Tatum Blvd #3096, Phoenix, AZ 85028 | 2017-11-14 |
| 1154840304 | Faustino M. Gonzalez, Md PC | Anesthesiology | 11811 N. Tatum Blvd, Suite 3031, Phoenix, AZ 85028 | 2017-09-19 |
| 1679092514 | Savior Palliative Care LLC | Family Medicine | 4530 E Shea Blvd Ste 175, Phoenix, AZ 85028 | 2017-09-12 |
| 1437688892 | Harmony Behavioral Health | Behavioral Analyst | 3008 E Sierra St, Phoenix, AZ 85028 | 2017-06-08 |
| 1275949224 | Alexander D Garza | Podiatrist | 3101 E Shea Blvd Ste 220, Phoenix, AZ 85028 | 2014-07-09 |
| 1720418379 | Alyssa Hale | Occupational Therapy Assistant | 4600 East Shea Boulevard, Suite 101, Phoenix, AZ 85028 | 2013-11-19 |
| 1932534476 | Stephen Howard Garber | Otolaryngology | 9607 N. 43rd Way, Phoenix, AZ 85028 | 2013-09-03 |
| 1366798050 | Irna Lynn Shamos | Clinical Neuropsychologist | 4516 East Onyx Avenue, Arizona Psychological Diagnostics, Plc, Phoenix, AZ 85028 | 2012-07-31 |
| 1285930925 | Cathy Ann Payne | Nurse Practitioner | 11209 N Tatum Blvd Ste 260, Phoenix, AZ 85028 | 2011-01-27 |
| Find all providers in zip 85028 | ||||
| Taxonomy Code | 2085N0904X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Nuclear Radiology |
| A radiologist who is involved in the analysis and imaging of radionuclides and radiolabeled substances in vitro and in vivo for diagnosis and the administration of radionuclides and radiolabeled substances for the treatment of disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457319642 | John R Bodker | Radiology | 2830 N 3rd St, Phoenix, AZ 85004-1042 | 2006-05-04 |
| 1780690610 | Allan R. Britt | Radiology | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2006-07-31 |
| 1720012156 | James Estes Seabold | Radiology | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2006-07-10 |
| 1477589075 | Valley Radiologists Ltd | Radiology | 2323 W Rose Garden Ln, Phoenix, AZ 85027-2530 | 2006-06-24 |
| 1730138751 | Bob A Lewis | Radiology | 11209 N Tatum Blvd, Suite #110, Phoenix, AZ 85028-3091 | 2006-05-08 |
| 1902896236 | Southwest Diagnostic Imaging Ltd | Radiology | 2323 W Rose Garden Ln, Phoenix, AZ 85027-2530 | 2005-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841846920 | Banner Imaging Services LLC | Radiology | 1828 E. Florence Blvd Bldg B Ste 118 & 128, Suite 118 and 128, Casa Grande, AZ 85122 | 2019-08-14 |
| 1326091786 | John Walter Millstine | Radiology | 3501 North Scottsdale Road, Suite 130, Scottsdale, AZ 85251 | 2006-05-18 |
| 1346210655 | David Anthony Emmerson | Radiology | 7158 E Desert Moon Loop, Tucson, AZ 85750-0918 | 2006-01-26 |
| 1932683257 | Associated Valley Radiologists Ltd | Radiology | 5605 W Eugie Ave Ste 110, Glendale, AZ 85304-1273 | 2018-09-21 |
| 1568805695 | Al Sardari | Radiology | 3601 S 6th Ave, Tucson, AZ 85723 | 2013-04-08 |
| 1609187418 | Icrc, P.C. | Radiology | 695 S Dobson Rd, Chandler, AZ 85224-5665 | 2010-06-25 |
| 1992925705 | Vasanti Deuskar | Radiology | 500 N. Hwy 89, Prescott, AZ 86313 | 2007-04-26 |
| 1174687388 | James M Woolfenden | Radiology | 1501 N Campbell Ave, Tucson, AZ 85724-0001 | 2006-12-21 |
| 1760557292 | Walter H Williams | Radiology | 1501 N Campbell Ave, Tucson, AZ 85724-0001 | 2006-11-21 |
| 1407823610 | Scottsdale Medical Imaging, Ltd | Radiology | 3501 N Scottsdale Rd, #130, Scottsdale, AZ 85251-5648 | 2006-03-07 |
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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.