Kevin D Bristowe, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

C10005371 Issued in DE

Practice address

424 Savannah Rd
Lewes, DE 19958

Phone

(302) 645-3296

Fax

(302) 645-3862

NPI assigned

Jan 10, 2006

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 2

Medicare fee-for-service enrollment

Enrolled in DE

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

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbristowe22636@beebehealth.direct-ci.com

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.

• Sussex Emergency Associates LLC

  • Emergency Medicine Physician
  • Lewes, DE
  • NPI 1275512105
  Medicare reassignment NPD

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1962481804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3012",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19804",
            "telephone_number": "302-224-5678",
            "fax_number": "302-224-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 SAVANNAH RD",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "19958",
            "telephone_number": "302-645-3296",
            "fax_number": "302-645-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTOWE",
        "first_name": "KEVIN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "DE",
            "license": "C10005371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000882401",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000882401",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daphne Brandt, RN
• Brandi Branscomb, RN
• Amanda Jo Brasure, RN
• Morgan Elizabeth Breasure, RN
• Kimberly Ann Brenner
• Broad Health, P.a.
• Sally Broadhurst, OT
• Catherine Brokaw
• Richard Brokaw
• Zachary E Bronder, DPT

• Emergency Medicine Physician in Lewes, DE
• Providers in Lewes, DE by specialty
• Emergency Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.