Kent Michael Patrick, MD

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

103500 Issued in MN

Practice address

717 S State St
Suite 900
Fairmont, MN 56031-4469

Phone

(507) 238-4949

Fax

(507) 238-3377

NPI assigned

Dec 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Kent M. Patrick, M.D., P.C.

  • Medical Specialty Clinic/Center
  • Yankton, SD
  • NPI 1619229556
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1134280324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 S STATE ST",
            "address_2": "SUITE 900",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314469",
            "telephone_number": "507-238-4949",
            "fax_number": "507-238-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S STATE ST",
            "address_2": "SUITE 900",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314469",
            "telephone_number": "507-238-4949",
            "fax_number": "507-238-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "KENT",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "C041516",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MN",
            "license": "103500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C415160",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "154N4PA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy M Paradis, PHARMD
• Kaci Lei Paradis, CNP
• Steven Edward Parnell, MD
• Mark Lee Paskey
• Patricia a Mahoney MD PA
• Myrna Joy Peters, MSN, RN, C-FNP
• Celia Marie Petrowiak
• Cody Petrowiak
• Whitney Philipp
• Shae Leann Pierson, RN, PHN

• Orthopaedic Surgery of the Spine Physician in Fairmont, MN
• Providers in Fairmont, MN by specialty
• Orthopaedic Surgery of the Spine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.