Kenneth R Adams, MD
Individual provider Active NPI Internal Medicine Physician · Rocky Mount, NC
NPI 1366446965 · NPPES record last updated Feb 15, 2019
Key facts
- NPI
- 1366446965
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 9700170 (NC)
- Practice address
- 901 N Winstead Ave
Rocky Mount, NC 27804-8467 - Phone
- (252) 937-0235
- Fax
- (252) 937-3103
- NPI assigned
- Jun 10, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060316000506 | NC | Practitioner - Internal Medicine | 3072520907 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9700170 | NC | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boice-Willis Clinic, PA | Current |
Accepting new patients | |
| Nash Hospitals Inc | Current |
Accepting new patients | |
| Boice-Willis Clinic PA | Internal Medicine | Current |
Accepting new patients |
| Nash Hospitals, Inc. | Current | Accepting new patients | |
| Nash Hospitals Inc | Current |
Accepting new patients |
Locations
921 N Winstead Ave
Rocky Mount, NC 27804
Phone (252) 937-0300
2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199
901 N Winstead Ave
Rocky Mount, NC 27804
Phone (252) 937-0200
91 Enterprise Dr
Rocky Mount, NC 27804
Phone (252) 451-3100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 9700170 | NC | Yes |
Addresses
Primary practice location
901 N Winstead Ave
Rocky Mount, NC 27804-8467
Mailing address
PO Box 7200
Rocky Mount, NC 27804-0200
Phone (252) 937-0200
Other practice location 1
91 Enterprise Dr
Rocky Mount, NC 27804-9590
Phone (252) 451-3200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8910343 | Medicaid | NC | |
| 4479932 | Other | NC | CIGNA HEALTHCARE |
| 10343 | Other | NC | BCBSNC |
| 110134039 | Other | NC | RAILROAD MEDICARE |
| 71753 | Other | NC | MEDCOST |
Other providers in Rocky Mount, NC
- Abundance Home Care Services LLC
- Ace Adult Family Care LLC
- Lexus Acklin
- Action Temporaries of Rocky Mount, Inc.
- Joseph Walter Adams
- Rick Scott Adams
- Tereon Nachon Adams
- Neal A Adkins Jr.
- Veronica Cooper Adkins
- Advance One Home Care Agency
All providers in Rocky Mount, NC · Internal Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.