KENNETH RANDAL PEARSON (MD) – Pediatrics Physician, NPI 1215029103
Pediatrics Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
521 PEDIATRIC MEDICINE in KY
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Provider Addresses for KENNETH RANDAL PEARSON (MD)
PO BOX 776879
CHICAGO, IL 606776879
Phone: (502) 272-5395
Fax: (502) 272-5339
Type: Mailing
Music Box Theatre, 3733, North Southport Avenue, Wrigleyville, Lake View, Lakeview, Chicago, Lake View Township, Cook County, Illinois, 60613, United States
CHICAGO, IL 606776351
Phone: (502) 588-9490
Fax: (502) 272-5116
Type: Mailing
Norton Orthopaedic Center, 9880, Angies Way, Old Brownsboro Crossing, Worthington, Louisville, Jefferson County, Kentucky, 40241, United States
STE 400
LOUISVILLE, KY 402412850
Phone: (502) 394-6500
Fax: (502) 394-1920
Type: Location
9880 ANGIES WAY STE 400
LOUISVILLE, KY 402412850
Phone: (502) 394-6500
Fax: (502) 394-1920
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $20.
Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.
Last reported payment date: 2023-02-24 • Largest payer in this snapshot: Tris Pharma Inc ($20).
Total Amount
$20
General + Research + Ownership
Payments
1
Total payment records
General Amount
$20
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-02-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Tris Pharma Inc | $20 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-02-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140205001365 | I | Pediatric Medicine | KY | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60677)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| - | KY | |
| N E U R O L O G Y | IL | |
| Emergency Medicine, Pediatric Medicine | IL | |
| Cardiovascular Disease (Cardiology) | IL | |
| - | KY | |
| - | KY | |
| O B S T E T R I C S/ G Y N E C O L O G Y | KY | |
| Diagnostic Radiology | IL | |
| Endocrinology, Internal Medicine, Pediatric Medicine | KY |
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