Provider Demographics
NPI:1750362430
Name:RHINEHART, KENNETH (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:
Last Name:RHINEHART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-996-7076
Mailing Address - Fax:336-996-7832
Practice Address - Street 1:1710 KERNERSVILLE MEDICAL PKWY STE 205
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-7156
Practice Address - Country:US
Practice Address - Phone:336-996-7076
Practice Address - Fax:336-996-7832
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238816207RC0000X
NC28794207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010196311Medicaid
1012OtherPARTNERS
NC71373OtherBCBS
E1592OtherMEDCOST
VA179317OtherANTHEM (W/S)
VA184341OtherANTHEM (GALAX)
VA010158222Medicaid
VA179318OtherANTHEM (MT. AIRY)
NC9521216OtherCIGNA HEALTHCARE
3867774OtherAETNA
NC8971373Medicaid
NCP00229571OtherMEDICARE RAILROAD
VA010158214Medicaid
VA1750362430Medicaid
NC203411AOtherFMH
4098566OtherAETNA
VA010158214Medicaid
NC9521216OtherCIGNA HEALTHCARE
VA010196311Medicaid
VA008764B98Medicare PIN