Individual ProviderKory LordPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1495 River Park Dr Ste 200, Sacramento, CA 95815-4517(916) 925-7020PECOS EnrollmentBased on the most recent information from CMS, provider Kory Lord is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1588303424Provider TypeIndividualFull NameLord, KoryCredentialPA-CGenderFemaleSole ProprietorNoEnumeration Date5/31/2022Last Updated3/12/2024Contact InformationPractice LocationPractice Address1495 River Park Dr Ste 200, Sacramento, CA 95815-4517Phone(916) 925-7020Fax(916) 925-3680Mailing LocationMailing Address1495 River Park Dr Ste 200, Sacramento, CA 95815-4517Phone(916) 925-7020Fax(916) 925-3680Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA61167California