Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1972653749 Deactivated / Inactive NPI Male Practitioner

Dr. Kenneth Dale Corwin , MD

General Practice • Saint Louis, MO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Kenneth Corwin has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 11, 2007
NPI Deactivation Date June 14, 2018
Total Practice Duration ~11 Years of Practice (2007 – 2018)

Professional Overview & Biography Verified Profile Summary

Dr. Kenneth Corwin, MD was a registered General Practice practicing in Saint Louis, MO. Throughout an active medical career spanning 11 years, Dr. Corwin provided care at the practice location at 77 WESTPORT PLZ until profile deactivation on 2018-06-14.

Practice Location & Contact Primary Location

Practice Address

77 Westport Plz
Suite365

Saint Louis, MO 631463107

Telephone 3145761911
Fax 3145760504
Associated Practice Facility / Clinic
🏢 Westport Periodontics P.c. Facility NPI 1902953391

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Saint Louis, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 22.1 Yrs
State Avg: 29.0 Yrs
Regional Practice Density
67 Specialists

Practicing in Saint Louis, MO (221 Statewide)

Telehealth Adoption Rate
7.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License MO 29950

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1104813831

Doctor of Dental Surgery

Thomas Schaberg , DDSMS

Dentist - Periodontics

NPI 1649327057
Dr. George Kyd , DDS

Dentist - Periodontics

NPI 1982751392

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 14, 2018

Record deactivated on June 14, 2018

NPI Profile Active May 28, 2013

NPI status registered as active in NPPES database

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Updated Practice Location May 28, 2013

Registered at 77 WESTPORT PLZ, SUITE365, SAINT LOUIS, MO 631463107 (Tel: 3145761911)

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Updated Business Mailing Address May 28, 2013

Registered at 77 WESTPORT PLZ, SUITE365, SAINT LOUIS, MO 631463107 (Tel: 3145761911)

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Provider Name / Credentials Updated May 28, 2013

Recorded as KENNETH CORWIN, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 28, 2013

General Practice (License #29950 in MO)

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Initial NPI Registration & Enumeration January 11, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1972653749
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 11, 2007
Last Update: May 28, 2013
Deactivation Date: June 14, 2018

Mailing Address

77 Westport Plz, Suite365

Saint Louis, MO 631463107

Phone: 3145761911

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.