Individual provider Active NPI

Charles Kevorkian, MD

  • Physical Medicine & Rehabilitation Physician
  • Houston, TX
National Provider Identifier
1326128687
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
F4906 Issued in TX
Practice address
6624 Fannin St
Suite 2330
Houston, TX 77030-2312
Phone
(713) 798-4061
Fax
(713) 796-0978
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X F4906 TX Primary

Addresses

Primary practice location

6624 Fannin St
Suite 2330
Houston, TX 77030-2312

Mailing address

6624 Fannin St
Suite 2330
Houston, TX 77030-2312
Phone (713) 798-4061

Other identifiers 1

IdentifierTypeStateIssuer
136171906MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ckevorkian6641@bcm.ghhdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20100330000850 TX Practitioner - Physical Medicine and Rehabilitation 7315073285 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
F4906TXMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Aug 1, 1979 Accepting new patients
Baylor College of Medicine Physical Medicine & Rehabilitation CurrentSince Aug 1, 1979 Accepting new patients
Baylor College of Medicine Physical Medicine & Rehabilitation CurrentSince Jan 27, 2014 Accepting new patients
Baylor College of Medicine CurrentSince Jan 27, 2014 Accepting new patients
Baylor College of Medicine Current Accepting new patients

Locations

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

7200 Cambridge St
Fl 10
Houston, TX 77030
Phone 7137981750 ext. 2

6624 Fannin St
Ste 2330
Houston, TX 77030
Phone (713) 798-4061

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

Organizations & group practices 5

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1326128687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6624 FANNIN ST",
            "address_2": "SUITE 2330",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302312",
            "telephone_number": "713-798-4061",
            "fax_number": "713-796-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6624 FANNIN ST",
            "address_2": "SUITE 2330",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302312",
            "telephone_number": "713-798-4061",
            "fax_number": "713-796-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEVORKIAN",
        "first_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "F4906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136171906",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckevorkian6641@bcm.ghhdirect.net",
            "affiliation": "N",
            "address_1": "7200 Cambridge St Fl 10",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770304202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.