Active NPI
Kerry W. Mays, MD
- Anesthesiology Physician
- Kokomo, IN
National Provider Identifier
1477577187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 01033285A
- Practice address
- 3500 S Lafountain St
Kokomo, IN 46902-3803 - Phone
- (765) 453-0702
- NPI assigned
- Jul 26, 2006
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 01033285A | IN | Primary |
Addresses
Primary practice location
3500 S Lafountain St
Kokomo, IN 46902-3803
Mailing address
PO Box 6005 Dept 196
Indianapolis, IN 46206-6005
Phone (317) 614-9817
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100228850A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583366400000",
"number": "1477577187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6005 DEPT 196",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462066005",
"telephone_number": "317-614-9817",
"fax_number": "317-614-9655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 S LAFOUNTAIN ST",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469023803",
"telephone_number": "765-453-0702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYS",
"first_name": "KERRY",
"middle_name": "W.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2020-03-05",
"certification_date": "2020-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IN",
"license": "01033285A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100228850A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.