Kokomo Urology Inc.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

KOKOMO UROLOGY INC.

Practice address

2345 W Lincoln Rd
Kokomo, IN 46902-8012

Phone

(765) 455-4075

Fax

(765) 455-4094

NPI assigned

Jul 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Willis W Peelle, M.D.NPI 1437146156

Title

President

Phone

(765) 455-4075

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Willis W Peelle, MD

  • Urology Physician
  • Kokomo, IN
  • NPI 1437146156
  Medicare reassignment NPD Authorized official
• James Michael Harshman, MD

  • Urology Physician
  • Kokomo, IN
  • NPI 1902896871
  Medicare reassignment NPD
• Stephen E Miller, D.O.

  • Urology Physician
  • Kokomo, IN
  • NPI 1295990414
  Medicare reassignment NPD
• Jessie Lee Myers, FNP

  • Family Nurse Practitioner
  • Kokomo, IN
  • NPI 1942677943
  Medicare reassignment NPD

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1104026160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 W LINCOLN RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469028012",
            "telephone_number": "765-455-4075",
            "fax_number": "765-455-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 W LINCOLN RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469028012",
            "telephone_number": "765-455-4075",
            "fax_number": "765-455-4094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOKOMO UROLOGY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "PEELLE",
        "authorized_official_first_name": "WILLIS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-455-4075",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100136840A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kokomo Place Assisted Living LLC
• Kokomo RCF LP
• Kokomo School Corporation
• Kokomo Sleep Center, LLC
• Kokomo Surgical Group, LLC
• Brooke Komar
• Steven Louis Konechnik, DPT
• Jennifer L Korreckt, BCBA
• Aaron Kosberg, DPT
• Blaine Krantz

• Urology Physician in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Urology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.