Kenneth P Barnes, M.D.
Individual provider Active NPI Sports Medicine (Internal Medicine) Physician · Summerfield, FL
NPI 1447338587 · NPPES record last updated May 2, 2025
Key facts
- NPI
- 1447338587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Sports Medicine (Internal Medicine) Physician 207RS0010X
- License
- ME139531 (FL)
- Practice address
- 17270 SE 109TH Terrace Rd
Summerfield, FL 34491-9015 - Phone
- (352) 336-6000
- NPI assigned
- Nov 2, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 33
Medicare Care Compare profile
- Specialty
- Sports Medicine
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Orthopaedic Institute, PA
Cora Health Services Inc
Practice addresses (Care Compare)
17270 SE 109TH Terrace Rd
Summerfield, FL 34491-9015
Phone (352) 633-7222
5036 SE 110TH St
Belleview, FL 34420-3759
Phone (352) 693-3378
8768 SE 165TH Mulberry LN
The Villages, FL 32162-5861
Phone (352) 329-5237
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190429002819 | FL | Practitioner - Sports Medicine |
4486750908 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2007-01088 | NC | MD | Sports Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Orthopaedic Institute, PA | Current |
Accepting new patients | |
| The Orthopaedic Institute PA | Current |
Accepting new patients | |
| Mercy Inpatient Medical Associates Inc. | Past |
Accepting new patients |
Locations
4500 Newberry Rd
Gainesville, FL 32607
Phone (352) 367-2310
146 SW Orthopedic Ct
Lake City, FL 32024
Phone (386) 755-9215
17270 SE 109th Terrace Rd
Summerfield, FL 34491
Phone (352) 336-0000
Interoperability endpoints
- kennethbarnes@go.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | 2007-01088 | NC | |
| Sports Medicine (Internal Medicine) Physician | 207RS0010X | ME139531 | FL | Yes |
| Sports Medicine (Emergency Medicine) Physician | 207PS0010X | ME139531 | FL | |
| Sports Medicine (Internal Medicine) Physician | 207RS0010X | 2007-01088 | NC | |
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | ME139531 | FL |
Addresses
Primary practice location
17270 SE 109TH Terrace Rd
Summerfield, FL 34491-9015
Mailing address
4500 Newberry Rd
Gainesville, FL 32607-2245
Phone (352) 336-6000
Other providers in Summerfield, FL
- Eniola Ayoola
- Carla Renee Bailey
- Catherine Baitinger
- Mary F Barber
- Leon Martin Bard
- Orlando Batista Fernandez
- Baylee Dental PA
- Be a Success Enterprises LLC
- Beach Cities Psychological Clinic, Inc.
- Luna Bella Beck
All providers in Summerfield, FL · Sports Medicine (Internal Medicine) Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.