Active NPI
Kevin Bird
- Physician Assistant
- Noblesville, IN
National Provider Identifier
1477043859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10002542A
- Practice address
- 493 Westfield Rd Ste a
Noblesville, IN 46060-1304 - Phone
- (317) 770-4100
- Fax
- (317) 770-4105
- NPI assigned
- May 11, 2018
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10002542A | IN | Primary |
Addresses
Primary practice location
493 Westfield Rd Ste a
Noblesville, IN 46060-1304
Mailing address
8751 Jaffa Court East Dr Apt 11
Indianapolis, IN 46260-2398
Phone (317) 308-0644
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300017857 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180910000335 | IN | Practitioner - Physician Assistant | 3779833926 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554422400000",
"number": "1477043859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8751 JAFFA COURT EAST DR APT 11",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462602398",
"telephone_number": "317-308-0644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "493 WESTFIELD RD STE A",
"city": "NOBLESVILLE",
"state": "IN",
"postal_code": "460601304",
"telephone_number": "317-770-4100",
"fax_number": "317-770-4105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIRD",
"first_name": "KEVIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-11",
"last_updated": "2019-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10002542A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300017857",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Noblesville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.