Basic Information
| Provider Information | |||||||||
| NPI: | 1245512870 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RINGGER | ||||||||
| FirstName: | KENT | ||||||||
| MiddleName: | PAUL | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | CAA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5307 MAIN ST | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | NEW PORT RICHEY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346522536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278451736 | ||||||||
| FaxNumber: | 7278490759 | ||||||||
| Practice Location | |||||||||
| Address1: | 5307 MAIN ST | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | NEW PORT RICHEY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346522536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278451736 | ||||||||
| FaxNumber: | 7278490759 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2011 | ||||||||
| LastUpdateDate: | 08/30/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367H00000X | 2011029434 | MO | N | Physician Assistants & Advanced Practice Nursing Providers | Anesthesiologist Assistant | 367H00000X | AA2013-001 | NM | N | Physician Assistants & Advanced Practice Nursing Providers | Anesthesiologist Assistant | 367H00000X | AA 337 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Anesthesiologist Assistant |
ID Information
| ID | Type | State | Issuer | Description | 2455064 | 05 | FL | MEDICAID | 2455064 | 05 | NM | MEDICAID | 2455064 | 05 | MO | MEDICAID |