Kenneth James Fellows

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

0101281167 Issued in VA

Practice address

3551 Roger Brooke Dr
Bamc, McHe-Zso, Orthopaedic Residency
Jbsa Ft Sam Houston, TX 78234-4504

Phone

(210) 916-1284

NPI assigned

Jan 27, 2022

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 names 1

• Kent Fellows Other name

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1922751221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "address_2": "MCHE ZSO DEPT ORTHOPAEDICS",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "address_2": "BAMC, MCHE-ZSO, ORTHOPAEDIC RESIDENCY",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLOWS",
        "first_name": "KENNETH",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-27",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101281167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENT",
            "last_name": "FELLOWS",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bukola Fagbemi, PHARM.D.
• Ryan A Fahey, MD
• Gabrielle Marie Collins Fannin, MD
• Alexandra Marie Fekete, DO
• Coral Feldman
• Stella S Feomaia, RN
• Joy Duer Ferre, MD
• Jakob Louis Fischer, MD
• Dane Michael Fishburn
• Miles William Adolphus Fisher, MD

• General Practice Physician in Jbsa Ft Sam Houston, TX
• Providers in Jbsa Ft Sam Houston, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.