Kenneth A Perez, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN226042 Issued in GA

Practice address

126 US Highway 280 W
Americus, GA 31719-8645

Phone

(229) 924-6011

NPI assigned

Nov 1, 2021

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoebe Physician Group IncGroup PAC ID 8426112350, 420 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phoebe Putney Memorial Hospital Hospital, Albany, GA, CCN 110007

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kenneth.perez.1@8478.direct.athenahealth.com
• Direct secure messaging: kenneth.perez@phoebehealth.gadirect.net

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.

• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment Care Compare group NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

• Phoebe Putney Memorial Hospital Inc

  • General Acute Care Hospital
  • Albany, GA
  • NPI 1992789721
  Care Compare affiliation

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1497410914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 PALMYRA RD STE 201",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011593",
            "telephone_number": "229-312-5863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 US HIGHWAY 280 W",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317198645",
            "telephone_number": "229-924-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "KENNETH",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN226042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "226042",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bobby L Payne Sr.
• Lori Jackson Payne, RPH
• Trent Joseph Peachey
• Colby Peavy
• Miranda Peck
• Perfect Care, Inc
• Latavia Perkins
• Perry Wellness Center
• Perry Wellness Center, Inc.
• Lori Perry

• Family Nurse Practitioner in Americus, GA
• Providers in Americus, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.
• 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.