Individual provider Active NPI

Kenneth Carl Followwill, D.P.M.

  • Podiatrist
  • Trophy Club, TX
National Provider Identifier
1376542795
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0760 Issued in TX
Practice address
2800 E Highway 114 Ste 210
Trophy Club, TX 76262
Phone
(817) 491-4345
Fax
(214) 350-2262
NPI assigned
Jul 18, 2005
Reactivated
Apr 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0760 TX Primary

Addresses

Primary practice location

2800 E Highway 114 Ste 210
Trophy Club, TX 76262

Mailing address

PO Box 543151
Dallas, TX 75354-3151
Phone (817) 491-4345

Other identifiers 1

IdentifierTypeStateIssuer
018810402MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
760TXMDElectroneurodiagnostic Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Foot Center, P.C. Podiatrist CurrentSince Feb 1, 2007 Accepting new patients

Locations

800 W Airport Fwy
Ste 110
Irving, TX 75062
Phone (214) 492-1970

2800 E Highway 114
Ste 210
Trophy Club, TX 76262
Phone (817) 491-4345

Organizations & group practices 1

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1376542795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 543151",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753543151",
            "telephone_number": "817-491-4345",
            "fax_number": "214-350-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E HIGHWAY 114 STE 210",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "76262",
            "telephone_number": "817-491-4345",
            "fax_number": "214-350-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLLOWWILL",
        "first_name": "KENNETH",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "0760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018810402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trophy Club, TX

Sources for this page

Verify at the official NPI Registry.