Kevin L Pritchett M.D PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036072222 Issued in IL

Legal business name

KEVIN L PRITCHETT M.D PC

Practice address

100 Springfield CT
O Fallon, IL 62269-2495

Phone

(618) 632-3565

Fax

(618) 632-7693

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kevin L Pritchett, M.D.

Title

President

Phone

(618) 632-3565

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236556800000",
    "number": "1902999683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SPRINGFIELD CT",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692495",
            "telephone_number": "618-632-3565",
            "fax_number": "618-632-7693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SPRINGFIELD CT",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692495",
            "telephone_number": "618-632-3565",
            "fax_number": "618-632-7693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN L PRITCHETT M.D PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2009-03-09",
        "status": "A",
        "authorized_official_last_name": "PRITCHETT",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-632-3565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036072222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00349295",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "214065",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in O Fallon, IL
• Providers in O Fallon, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.