Active NPI
Kevin Brashear
- Dentist
- Booneville, KY
National Provider Identifier
1326613100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10608
- Practice address
- 826 Ky 11 N
Booneville, KY 41314-9155 - Phone
- (606) 593-6395
- Fax
- (606) 593-5916
- NPI assigned
- May 24, 2021
- Last updated
- May 24, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 10608 | KY | Primary |
Addresses
Primary practice location
826 Ky 11 N
Booneville, KY 41314-9155
Mailing address
PO Box 40
Whitesburg, KY 41858-0040
Phone (606) 633-4823
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210622001013 | KY | Order and Referring Only - Dentist | 5698176105 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- kevin.brashear.p1@direct.mtncomp.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621814400000",
"number": "1326613100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 40",
"city": "WHITESBURG",
"state": "KY",
"postal_code": "418580040",
"telephone_number": "606-633-4823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "826 KY 11 N",
"city": "BOONEVILLE",
"state": "KY",
"postal_code": "413149155",
"telephone_number": "606-593-6395",
"fax_number": "606-593-5916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRASHEAR",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-24",
"last_updated": "2021-05-24",
"certification_date": "2021-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "10608",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Booneville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.