Kevin M Pridemore, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

004120 Issued in KY

Practice address

1051 Newtown Pike
Suite H-J
Lexington, KY 40511

Phone

(859) 253-0758

Fax

(859) 253-0890

NPI assigned

Jun 19, 2008

Last updated

Dec 8, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

94.29 of 100Reported as apm

Quality

87.32

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Baptist Health Medical Group Inc

  dba Dawson Springs Rural Health Clinic

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  Medicare reassignment NPD
• Baptist Health Medical Group Inc

  • Urgent Care Clinic/Center
  • Louisville, KY
  • NPI 1508269200

  Physical Therapist

  NPD

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1477714855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950248",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950248",
            "telephone_number": "502-489-5730",
            "fax_number": "502-489-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 NEWTOWN PIKE",
            "address_2": "SUITE H-J",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40511",
            "telephone_number": "859-253-0758",
            "fax_number": "859-253-0890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 Fountain Ct Ste 325",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405092167",
            "country_code": "US",
            "telephone_number": "859-263-0595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRIDEMORE",
        "first_name": "KEVIN",
        "middle_name": "M",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "004120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpridemore9999@bhkydirect.com",
            "affiliation": "N",
            "address_1": "230 Fountain Ct Ste 325",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405092167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tyran Price, MSW, CSW
• Hannah Nicole Prichard, MS, OTR/L
• Rebecca Prichard
• Trisha Prickett
• Rachel Faith Priddy, PHARMD
• Stephanie K Pridemore, PA
• Stephanie Priest, APRN, DNP
• Primary Care Associates, PSC
• Daniel Deaton Primm, M.D.
• Lisa Carole Primm, ARNP

• Physical Therapist in Lexington, KY
• Providers in Lexington, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.