Kennon Mark Little, is a medicare enrolled "Physical Therapist" provider in Attica, Indiana. His current practice location is
1111 E Main St, Attica, Indiana. You can reach out to his office (for appointments etc.) via phone at
(765) 299-3259.
Kennon Mark Little is licensed to practice in Indiana (license number 05014715A) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1740042266.
Healthcare Provider's Profile
Full Name | Kennon Mark Little |
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Gender | Male |
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Speciality | Physical Therapist |
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Location | 1111 E Main St, Attica, Indiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1740042266
- Provider Enumeration Date: 01/29/2024
- Last Update Date: 02/03/2024
Medicare PECOS Information:
- PECOS PAC ID: 8729519269
- Enrollment ID: I20241223002422
Medical Identifiers
Medical identifiers for Kennon Mark Little such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1740042266 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225100000X | Physical Therapist | 05014715A (Indiana) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kennon Mark Little allows following entities to bill medicare on his behalf.
Provider Name | Little Physical Therapy Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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Provider Identifiers | NPI Number: 1326801119 PECOS PAC ID: 7810428356 Enrollment ID: O20241008001591 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kennon Mark Little is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kennon Mark Little, 2251 E 50 S, Attica, IN 47918-7834 Ph: () - | Kennon Mark Little, 1111 E Main St, Attica, IN 47918-1949 Ph: (765) 299-3259 |
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