KENNETH DEAVER, MD — NPI 1649632878 (Licensed & Credentialed Allopathic & Osteopathic Physicians

CMS-1500 Box 24J / 33a • NPI

1649632878

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

208M00000X (CMS C6)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist

Box 32 Service Location & ZIP+4

301 WALNUT ST, AMITE, LA, 70422-2025

✓ 9-Digit EDI 837 ZIP+4 (70422-2025)

Practice Phone & Referral Fax

(985) 748-9485

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1649632878 (KENNETH DEAVER, MD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1649632878` (NPI-1 Individual Practitioner)
Provider / Legal Name	KENNETH DEAVER, MD
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist NUCC Code: `208M00000X` (Hospitalist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	301 WALNUT ST, AMITE, LA, 70422-2025
Practice Telephone / Fax	Tel: (985) 748-9485
Administrative Mailing Address	9333 IMPERIAL HWY, DOWNEY, CA, 90242-2812
Enumeration & Last Sync	Enumerated: 2016-03-26 \| CMS Record Updated: 2021-11-29

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

301 WALNUT ST, AMITE, LA, 70422-2025

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Plain-English Taxonomy & CMS Crosswalk (208M00000X)

What Does Taxonomy Code 208M00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208M00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist"

CMS-1500 Medicare Specialty Crosswalk: CMS Code C6 (Physician/Hospitalist)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Hospitalist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KENNETH DEAVER, MD)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207P00000X` — Emergency Medicine Plain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)	State: LA \| License: `320128` \| Primary: Secondary
`208M00000X` — Hospitalist Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist	State: CA \| License: `167908` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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KENNETH DEAVER, MD (NPI #1649632878)