DR. KENNETH STARR M.D. NPI 1861431595

NPI Information

NPI: 1861431595
Provider Name: DR. KENNETH STARR, M.D.
Classification: Internal Medicine - 207RA0401X
Entity Type: Individual

Specialization: Addiction Medicine

PECOS Registration: Yes

Address:
107 NELSON ST
ARROYO GRANDE, CA
ZIP 93420
Phone: (805) 242-1360
Get Directions

DR. Kenneth Starr, M.D. is an addiction medicine internal medicine in Arroyo Grande, CA. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. DR. Kenneth Starr, M.D. NPI is 1861431595. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

107 NELSON ST
ARROYO GRANDE, CA
ZIP 93420-318
Phone: (805) 242-1360

The NPI 1861431595 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/6/2006 and was last updated on 6/7/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207P00000X	Emergency Medicine		MD22323O	OREGON	No
2	207RA0401X	Internal Medicine	Addiction Medicine	A105044	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	A032	OTHER		CHAMPUS
2	H00866	OTHER		CHAMPUS
3	H00866	OTHER		GROUP HEALTH
4	H00866	OTHER		LIPA
5	057221014	OTHER		BCBS
6	288397	MEDICAID	OREGON
7	8283574	MEDICAID	WASHINGTON
8	XPY196669	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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