Individual
DR. KENNETH ALLAN MOOK
Active
Individual
DR. KENNETH ALLAN MOOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
31321
KY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
335350
LA
208100000X
Physical Medicine & Rehabilitation Physician
88900
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000074661
ANTHEM PROVIDER #
KY
01
—
1102772
PASSPORT
KY
05
—
200179480
—
IN
01
—
2436318000
PASSPORT ADVANTAGE
KY
01
—
61-1086535
TAX ID
KY
05
—
64-313216
—
KY
05
—
64313216
—
KY
Enumeration date
02/14/2006
Last updated
10/30/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up