Kevin T Powell, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2007034233 Issued in MO

Practice address

1465 S Grand Blvd
Saint Louis, MO 63104-1003

Phone

(314) 268-4101

Fax

(314) 577-5379

NPI assigned

Nov 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Ascension Medical Group-Southeast Wisconsin Inc

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077

  Pediatrics

  Medicare reassignment NPD

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1043389489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-268-4101",
            "fax_number": "314-577-5379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-268-4101",
            "fax_number": "314-577-5379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "KEVIN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2007034233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane J Powell, PH.D., L.P.C.
• Garren Matthew Powell, MD
• Jill K Powell, M.D.
• Kenneth Powell Jr., PHARMD
• Kenneth Senior Powell II, D.D.S.
• Marquita S Powell
• Matthew Powell, MD
• Matthew A Powell, MD
• Mitchell Vincent Powell, DPT
• Morgan Powell

• Pediatrics Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.