Kenneth J Parker, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

168155 Issued in WV

Practice address

109 Morrison Dr
Princeton, WV 24740-2322

Phone

(304) 487-3559

Fax

(304) 487-7928

NPI assigned

Dec 4, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• East River Anesthesiology Inc

  • Anesthesiology Physician
  • Princeton, WV
  • NPI 1740711795
  NPD Authorized official
• Princeton Community Hospital Assn., Inc

  • Rural Health Clinic/Center
  • Bluefield, VA
  • NPI 1235446485
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1295893360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1143",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247401143",
            "telephone_number": "304-487-3559",
            "fax_number": "304-487-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 MORRISON DR",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402322",
            "telephone_number": "304-487-3559",
            "fax_number": "304-487-7928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "KENNETH",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WV",
            "license": "168155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0059772000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelly Denise Pack, FNP
• Natalie Page, MA, CCC-SLP
• Tiffany Palmer, PRSS
• Vivian Elaine Palmer
• Gopal M Pardasani, MD
• Christopher Darin Parrish, D.O.
• Kayla A Parsons, CMT
• Brooke D Paskowski
• Troyleena Pate
• Dilip B Patel, M.D.

• Anesthesiology Physician in Princeton, WV
• Providers in Princeton, WV by specialty
• Anesthesiology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; 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.