Active NPI
Kevin L Pritchett, M.D.
- Family Medicine Physician
- O Fallon, IL
National Provider Identifier
1174522197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036072222
- Practice address
- 100 Springfield CT
O Fallon, IL 62269-2495 - Phone
- (618) 632-3565
- Fax
- (618) 632-7693
- NPI assigned
- Jul 20, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036072222 | IL | Primary |
Addresses
Primary practice location
100 Springfield CT
O Fallon, IL 62269-2495
Mailing address
100 Springfield CT
O Fallon, IL 62269-2495
Phone (618) 632-3565
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00349295 | Other | IL | MEDICARE RAILROAD |
| 036072222 | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kpritchett100334@ewd.direct.hshs.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- kpritchett100334@ewd.direct.hshs.org
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640649600000",
"number": "1174522197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 SPRINGFIELD CT",
"city": "O FALLON",
"state": "IL",
"postal_code": "622692495",
"telephone_number": "618-632-3565",
"fax_number": "618-632-7693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 SPRINGFIELD CT",
"city": "O FALLON",
"state": "IL",
"postal_code": "622692495",
"telephone_number": "618-632-3565",
"fax_number": "618-632-7693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRITCHETT",
"first_name": "KEVIN",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-20",
"last_updated": "2021-12-28",
"certification_date": "2021-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036072222",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00349295",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036072222",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kpritchett100334@ewd.direct.hshs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "100 Springfield Ct",
"city": "O Fallon",
"state": "IL",
"country_code": "US",
"postal_code": "622692495",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in O Fallon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.