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Deactivated NPI 1124090600 Deactivated / Inactive NPI Male Practitioner

Dr. Kenneth Dean Draper , MD

General Practice • Iuka, MS

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Kenneth Draper has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 07, 2006
NPI Deactivation Date August 24, 2020
Total Practice Duration ~14 Years of Practice (2006 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Kenneth Draper, MD was a registered General Practice practicing in Iuka, MS. Throughout an active medical career spanning 14 years, Dr. Draper provided care at the practice location at 1413 W QUITMAN ST until profile deactivation on 2020-08-24.

Practice Location & Contact Primary Location

Practice Address

1413 W Quitman St

Iuka, MS 388521130

Telephone 6624249550
Fax 6624249558
Associated Practice Facility / Clinic
🏢 Avalon Medical Llc Facility NPI 1710216346

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Iuka, MS

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 27.8 Yrs
Regional Practice Density
1 Specialists

Practicing in Iuka, MS (91 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License MS 05055

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Dr. Thomas Draper , MD

Family Medicine

NPI 1144363987

Doctor of Medicine (M.D.)

Theresa Massey , FNP

Nurse Practitioner - Family

NPI 1225123086

Family Nurse Practitioner

Michelle Draper , FNP-BC

Nurse Practitioner

NPI 1457083503

Family Nurse Practitioner (Board Certified)

Jennifer Dawson , NURSE PRACTITIONER

Nurse Practitioner - Family

NPI 1710959283

NURSEPRACTITIONER

Pamela Thompson , FNP-BC

Nurse Practitioner - Family

NPI 1912600404

Family Nurse Practitioner (Board Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 24, 2020

Record deactivated on August 24, 2020

NPI Profile Active March 17, 2010

NPI status registered as active in NPPES database

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Updated Practice Location March 17, 2010

Registered at 1413 W QUITMAN ST, IUKA, MS 388521130 (Tel: 6624249550)

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Updated Business Mailing Address March 17, 2010

Registered at 1413 W QUITMAN ST, IUKA, MS 388521130 (Tel: 6624249550)

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Provider Name / Credentials Updated March 17, 2010

Recorded as KENNETH DRAPER, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2010

General Practice (License #05055 in MS)

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Initial NPI Registration & Enumeration February 07, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124090600
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 07, 2006
Last Update: March 17, 2010
Deactivation Date: August 24, 2020

Mailing Address

1413 W Quitman St

Iuka, MS 388521130

Phone: 6624249550

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.