Active NPI
Kenneth Carl Followwill, D.P.M.
- Podiatrist
- Trophy Club, TX
National Provider Identifier
1376542795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 0760
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 018810402 | Medicaid | TX |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 760 | TX | MD | Electroneurodiagnostic Specialist/Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affiliated Foot Center, P.C. | Podiatrist | Current | 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.
-
- Podiatrist
- Trophy Club, TX
- NPI 1083837421
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.