Individual provider Active NPI

Kelvin D Perry, M.D.

  • Family Medicine Physician
  • Corbin, KY
National Provider Identifier
1972696672
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40246 Issued in KY
Practice address
121 Bishop St
Corbin, KY 40701-1702
Phone
(606) 528-2124
Fax
(606) 528-8272
NPI assigned
Oct 2, 2006
Last updated
Nov 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 40246 KY Primary

Addresses

Primary practice location

121 Bishop St
Corbin, KY 40701-1702

Mailing address

121 Bishop St
Corbin, KY 40701-1702
Phone (606) 528-2124

Other identifiers 1

IdentifierTypeStateIssuer
7100005480MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20070604000673 KY Practitioner - Family Practice 7618906553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

14662 N US Hwy 25 E
Corbin, KY 40701-6425
Phone (606) 526-9005

313 S Cherry St
Pineville, KY 40977-1724
Phone (606) 654-3338

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Community Health Center, Inc. CurrentSince May 1, 2016 Accepting new patients
Grace Community Health Center, Inc. Family Medicine Current Accepting new patients
Grace Community Health Center, Inc. Family Medicine CurrentSince May 1, 2016 Accepting new patients

Locations

1019 Cumberland Falls Hwy
Ste B201
Corbin, KY 40701

121 Bishop St
Corbin, KY 40701
Phone (606) 258-8837

14662 N US Highway 25 E
Corbin, KY 40701
Phone (606) 526-9005

39 Cumberland Gap Plz
Gray, KY 40734
Phone (606) 526-9005

21154 Highway 421
Ste 1
Hyden, KY 41749

272 London Mountain View Dr
London, KY 40741
Phone (606) 231-2614

85 Highway 80
Manchester, KY 40962
Phone (606) 596-0410

313 S Cherry St
Pineville, KY 40977
Phone (606) 654-3338

Interoperability endpoints

  • Direct secure messaging: kperry704220@direct.ochin.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1972696672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 BISHOP ST",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407011702",
            "telephone_number": "606-528-2124",
            "fax_number": "606-528-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BISHOP ST",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407011702",
            "telephone_number": "606-528-2124",
            "fax_number": "606-528-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "KELVIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "40246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100005480",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.