DR. KIM E PERSHALL (NPI# 1497751663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497751663 |
| Entity Type | Individual |
| Full Name | DR. KIM E PERSHALL |
| Credential | MD |
| Practice Address |
3811 24th Street Lubbock TX 79410-1813 |
| Practice Telephone | 8067960202 |
| Practice Fax Number | 8067960496 |
| Mailing Telephone | 8067960202 |
| Mailing Fax Number | 8067960496 |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2011-01-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 86103 | NM | Other Service Providers |
| N | 174400000X | Specialist | J3574 | TX | Other Service Providers |
| Y | 207Y00000X | Otolaryngology | J3574 | TX | Allopathic & Osteopathic Physicians |
| N | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
J3574 | TX | Allopathic & Osteopathic Physicians |
| N | 207YX0602X |
Otolaryngology Specialization: Otolaryngic Allergy |
J3574 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 37234 | 05 | |
| TX | MEDICARE PTAN | 8F21125 | 01 |
| TX | 034333701 | 05 | |
| TX | RAILROAD MEDICARE | 040007969 | 01 |
| TX | MEDICAID GROUP | 148127701 | 01 |
| TX | FIRSTCARE | 121351100 | 01 |
| TX | BCBS TX | 8P8420 | 01 |
| Street Address |
3811 24TH STREET |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79410-1813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649456542 | Kim E Pershall Md Pa | Otolaryngology | 3811 24th Street, Lubbock, TX 79410-1813 | 2008-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548878267 | Covenant Medical Center | Clinic/Center | 3615 19th, Lifestyle Centre-east Parking Garage, Lubbock, TX 79410 | 2020-07-20 |
| 1669038626 | Hub City Anesthesia | Nurse Anesthetist, Certified Registered | 3416 22nd Street, Lubbock, TX 79410 | 2019-05-15 |
| 1912447418 | Lubbock Surgery Center, LLC | Clinic/Center | 3416 22nd St, Lubbock, TX 79410 | 2017-03-02 |
| 1871032698 | Lezlee Berry | Pharmacist | 3615 19th Street, Lubbock, TX 79410 | 2017-02-13 |
| 1376914101 | Matthew Cotton | Nurse Practitioner | 2424 Quaker Ave, Lubbock, TX 79410 | 2015-10-20 |
| 1841534864 | Frank Nwabugwu | Pharmacist | 4120 34th Street, Lubbock, TX 79410 | 2012-11-15 |
| 1689954794 | Dharmendra Kumar | Pediatrics | Covenant Children's Hospital, 4000 24th Street, Lubbock, TX 79410 | 2011-08-19 |
| 1518277177 | T.r.m. Rao, M.d., P.a. | Colon & Rectal Surgery | 3809 22nd Street, Suite C, Lubbock, TX 79410 | 2010-10-18 |
| 1700196672 | Hanford Consultations P.a. | Family Medicine | 4000 22nd Place Suite 100, Lubbock, TX 79410 | 2010-10-13 |
| 1336452598 | Amanda Collins | Specialist | 4801 34th Street, Lubbock, TX 79410 | 2010-07-16 |
| Find all providers in zip 79410 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609961812 | Philip Alan Scolaro | Otolaryngology | 3802 22nd St, Suite 200, Lubbock, TX 79410-1107 | 2006-10-04 |
| 1134112865 | William Russell Fell | Otolaryngology | 3802 22nd, #100, Lubbock, TX 79410 | 2005-08-29 |
| 1740283571 | Mark L. Winter | Otolaryngology | 4432 S Loop 289, Lubbock, TX 79414-5005 | 2005-05-24 |
| 1023539426 | Rahul Mahendra Varman | Otolaryngology | 3601 4th St # Ms 8312, Lubbock, TX 79430-0002 | 2017-07-06 |
| 1790019784 | Ear Nose and Throat Associates of Lubbock Pa | Otolaryngology | 3802 22nd St, Suite 200, Lubbock, TX 79410-1107 | 2009-09-24 |
| 1649456542 | Kim E Pershall Md Pa | Otolaryngology | 3811 24th Street, Lubbock, TX 79410-1813 | 2008-01-10 |
| 1063632974 | Joshua Charles Demke | Otolaryngology | 3601 4th St Fl 4, Lubbock, TX 79430-0002 | 2007-04-26 |
| 1124177423 | Sanford T. Ward, D.o., Professional Associatiion | Otolaryngology | 3719 22nd St, Lubbock, TX 79410-1329 | 2007-01-09 |
| 1043259112 | Thomas F Neal | Otolaryngology | 3621 22nd St, Ste 300, Lubbock, TX 79410-1301 | 2006-06-05 |
| 1548209810 | Stan E Potocki | Otolaryngology | 3621 22nd St, Ste 300, Lubbock, TX 79410-1301 | 2006-06-05 |
| Find all providers in LUBBOCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.