MEDICARE: MR. KENNETH THORPE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1790596732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KENNETH THORPE

Provider Business Mailing Address
First Line	:	8063 MADISON AVE # 1135
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-6001
Country	:	US
Telephone Number	:	574-241-6690
Fax Number	:

Provider Business Practice Location Address
First Line	:	4505 ESTATE LN APT 9
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46221-2517
Country	:	US
Telephone Number	:	773-354-8716
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2025
Last Update Date	:	01/17/2025

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Directions to “ MR. KENNETH THORPE ” Practice Location

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