Kevin L. Preston, D.O.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

3502 Issued in SD

Practice address

101 Tower Road
Suite 100
Dakota Dunes, SD 57049

Phone

(605) 217-4310

Fax

(605) 217-2915

NPI assigned

Feb 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in IA, SD2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1139011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1396717229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 TOWER ROAD",
            "address_2": "SUITE 100",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "57049",
            "telephone_number": "605-217-4310",
            "fax_number": "605-217-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 TOWER ROAD",
            "address_2": "SUITE 100",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "57049",
            "telephone_number": "605-217-4310",
            "fax_number": "605-217-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "KEVIN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-04",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IA",
            "license": "02660",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "SD",
            "license": "3502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0004023",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42140591500",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "12129",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1074542",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7797132",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Kaye Pospischil, NP
• Jeremy Poulsen, DO
• Sarah P Powell, M.D.
• John B Pracyk, MD, PHD, MBA
• Thomas George Pratt, O.D.
• Jessica A Prewitt-Emerson, PA-C
• Samantha Paige Protexter, DPT
• Adnan A. Qalbani, M.D.
• Fahima A Qalbani, M.D.
• Thorir Sturla Ragnarsson, MD

• Gastroenterology Physician in Dakota Dunes, SD
• Providers in Dakota Dunes, SD by specialty
• Gastroenterology Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; 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.

Verify at the official NPI Registry.