Kent Ian Kossoy, MD

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

J0558 Issued in TX

Practice address

2100 Highway 61 N
Vicksburg, MS 39183-8211

Phone

(601) 883-6300

NPI assigned

Nov 7, 2005

Last updated

Sep 14, 2020By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cardiovascular Care Providers, Inc.

  • Specialist
  • Houston, TX
  • NPI 1437242617
  NPD (past)
• Jonathan Redmon MD PA

  • Surgery Physician
  • Humble, TX
  • NPI 1538481031
  NPD (past)

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1356322416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 SHELTERING OAKS LN",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773452187",
            "telephone_number": "832-335-8245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838211",
            "telephone_number": "601-883-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSSOY",
        "first_name": "KENT",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "TX",
            "license": "J0558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123261307",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "keny.kossoy.1@1475.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "2100 Highway 61 N",
            "city": "Vicksburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "391838211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Theresa Shelly King, RCP
• Aimee Robinson Kinnebrew
• Samantha Rose Klein, DPT
• Miranda Knight
• Angela J. Koestler, PH.D.
• KPC Promise Hospital of Vicksburg LLC
• Kristi Kraft
• Kroger Limited Partnership I (Kroger Pharmacy)
• Kroger Limited Partnership I (Kroger Pharmacy)
• Allison Kurtz

• Colon & Rectal Surgery Physician in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Colon & Rectal Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.