Individual provider Active NPI

Kenneth Scott Pacer, MD

  • Psychiatry Physician
  • Kent, OH
National Provider Identifier
1033237300
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35-065749 Issued in OH
Practice address
5982 Rhodes Rd
Kent, OH 44240-4128
Phone
(330) 673-1347
Fax
(330) 678-3677
NPI assigned
Mar 26, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35-065749 OH Primary

Addresses

Primary practice location

5982 Rhodes Rd
Kent, OH 44240-4128

Mailing address

5982 Rhodes Rd
Kent, OH 44240-4128
Phone (330) 673-1347

Other identifiers 1

IdentifierTypeStateIssuer
0148754MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090608000413 OH Practitioner - Psychiatry 5294885570 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Ohio State University College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3920 Lovers LN
Ravenna, OH 44266-4200
Phone (330) 673-1347

3922 Lovers LN
Ravenna, OH 44266-4200
Phone (330) 673-1347

5982 Rhodes Rd
Kent, OH 44240-4128

5982 Rhodes Rd
Kent, OH 44240-8100
Phone (330) 673-1347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-065749OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coleman Professional Services, Inc. Psychiatry CurrentSince Apr 14, 2009 Accepting new patients

Locations

5982 Rhodes Rd
Kent, OH 44240
Phone (330) 676-6875

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1033237300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5982 RHODES RD",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404128",
            "telephone_number": "330-673-1347",
            "fax_number": "330-678-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5982 RHODES RD",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404128",
            "telephone_number": "330-673-1347",
            "fax_number": "330-678-3677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACER",
        "first_name": "KENNETH",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35-065749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0148754",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, OH

Sources for this page

Verify at the official NPI Registry.