Active NPI
Kenneth Mack Perkins, DC
- Chiropractor
- Conroe, TX
National Provider Identifier
1497860407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2568
- Practice address
- 701 Old Montgomery Rd
Conroe, TX 77301 - Phone
- (936) 539-9299
- Fax
- (936) 539-9298
- NPI assigned
- Aug 20, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2568 | TX | Primary |
Addresses
Primary practice location
701 Old Montgomery Rd
Conroe, TX 77301
Mailing address
PO Box 2705
Conroe, TX 77305-2705
Phone (936) 539-9299
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 088350601 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110427000095 | TX | Practitioner - Chiropractic | 3870778343 | Practice locations: Conroe, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- University of Pasadena College of Chiropractic, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3504 W Davis
Conroe, TX 77304-1832
Phone (936) 539-9299
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497860407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2705",
"city": "CONROE",
"state": "TX",
"postal_code": "773052705",
"telephone_number": "936-539-9299",
"fax_number": "936-539-9298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 OLD MONTGOMERY RD",
"city": "CONROE",
"state": "TX",
"postal_code": "77301",
"telephone_number": "936-539-9299",
"fax_number": "936-539-9298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERKINS",
"first_name": "KENNETH",
"middle_name": "MACK",
"name_prefix": "Mr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "2568",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "088350601",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conroe, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.