Kevin D Boyd, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036.086462 Issued in IL

Practice address

2 Saint Anthonys Way
Suite 205
Alton, IL 62002-4569

Phone

(618) 462-2222

Fax

(618) 463-5004

NPI assigned

Aug 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1407962012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SAINT ANTHONYS WAY",
            "address_2": "SUITE 205",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024569",
            "telephone_number": "618-462-2222",
            "fax_number": "618-462-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SAINT ANTHONYS WAY",
            "address_2": "SUITE 205",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024569",
            "telephone_number": "618-462-2222",
            "fax_number": "618-463-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "KEVIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036086462",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.086462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036054127",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110191310",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Ann Bogowith, PT
• Leanne Marie Bonnell, D.P.T.
• Tameco Booth
• Dana Bourland, BA
• Roy Dale Bower, D.M.D.
• Tobin T Boyd, DMD
• Leesa Boyer
• Brad McMillin, Inc.
• Bradley W Roberts DMD PC
• Laura L Brandenburg, FNP

• Family Medicine Physician in Alton, IL
• Providers in Alton, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.