Individual provider Active NPI

Kenneth R Adams, MD

  • Internal Medicine Physician
  • Rocky Mount, NC
National Provider Identifier
1366446965
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9700170 Issued in 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
Last updated
Feb 15, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9700170 NC Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20060316000506 NC Practitioner - Internal Medicine 3072520907 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9700170NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nash Hospitals Inc CurrentSince Feb 12, 2014 Accepting new patients
Nash Hospitals Inc CurrentSince Feb 12, 2014 Accepting new patients
Boice-Willis Clinic PA Internal Medicine CurrentSince Aug 1, 1997 Accepting new patients
Boice-Willis Clinic, PA CurrentSince Aug 1, 1997 Accepting new patients
Nash Hospitals, Inc. Current Accepting new patients

Locations

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

921 N Winstead Ave
Rocky Mount, NC 27804
Phone (252) 937-0300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1366446965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7200",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278040200",
            "telephone_number": "252-937-0200",
            "fax_number": "252-451-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N WINSTEAD AVE",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048467",
            "telephone_number": "252-937-0235",
            "fax_number": "252-937-3103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91 Enterprise Dr",
            "address_purpose": "LOCATION",
            "city": "Rocky Mount",
            "state": "NC",
            "postal_code": "278049590",
            "country_code": "US",
            "telephone_number": "252-451-3200",
            "fax_number": "252-937-3107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "KENNETH",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9700170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

Verify at the official NPI Registry.