Individual provider Active NPI

Kevin M Marberry, MD

  • Orthopaedic Surgery Physician
  • Hannibal, MO
National Provider Identifier
1417995523
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
119051 Issued in MO
Practice address
6500 Hospital Dr
Hannibal, MO 63401-6890
Phone
(573) 629-3410
Fax
(573) 629-3335
NPI assigned
Jun 2, 2006
Last updated
Dec 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 119051 MO Primary

Addresses

Primary practice location

6500 Hospital Dr
Hannibal, MO 63401-6890

Mailing address

PO Box 1239
Hannibal, MO 63401-1239
Phone (573) 406-5930

Other identifiers 1

IdentifierTypeStateIssuer
209216704MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kevin.marberry.3@2245.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20041006000814 MO Practitioner - Orthopedic Surgery 8325007289 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Missouri, Columbia School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kirksville Clinic CorpGroup PAC ID 4486619269, 14 clinicians

Practice addresses (Care Compare)

315 S Osteopathy Ave
Kirksville, MO 63501-6401
Phone (660) 785-1000

6500 Hospital Dr
Hannibal, MO 63401-6890
Phone (573) 248-1300

800 W Jefferson St
Kirksville, MO 63501-1443
Phone (660) 626-2235

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement12
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
119051MOMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hannibal Regional Healthcare System Inc CurrentSince Jan 5, 2026 Accepting new patients
Hannibal Regional Healthcare System, Inc CurrentSince Jan 5, 2026 Accepting new patients
Kirksville Clinic Corp Orthopaedic Surgery CurrentSince Jan 1, 2014 Accepting new patients
Hannibal Regional Healthcare System, Inc Past Accepting new patients

Locations

6500 Hospital Dr
Hannibal, MO 63401
Phone (573) 629-3400

800 W Jefferson St
Kirksville, MO 63501
Phone (660) 626-2235

800 W Jefferson St
Fl 1
Kirksville, MO 63501

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
  • Direct secure messaging: kevin.marberry.3@2245.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1417995523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634011239",
            "telephone_number": "573-406-5930",
            "fax_number": "573-248-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 HOSPITAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016890",
            "telephone_number": "573-629-3410",
            "fax_number": "573-629-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARBERRY",
        "first_name": "KEVIN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "119051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209216704",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kevin.marberry.3@2245.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1947 N Founders Cir",
            "city": "Wichita",
            "state": "KS",
            "country_code": "US",
            "postal_code": "672063548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.