Active NPI
Kaili Ann McKernan
- Counselor
- Wyomissing, PA
National Provider Identifier
1003381328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- APC000258
- Practice address
- 7 Bristol CT
Wyomissing, PA 19610-1805 - Phone
- (484) 706-9465
- NPI assigned
- Oct 12, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | APC000258 | PA | Primary |
Addresses
Primary practice location
7 Bristol CT
Wyomissing, PA 19610-1805
Mailing address
7 Bristol CT
Wyomissing, PA 19610-1805
Phone (484) 706-9465
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 483106300 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APC000258 | PA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723766400000",
"number": "1003381328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 BRISTOL CT",
"city": "WYOMISSING",
"state": "PA",
"postal_code": "196101805",
"telephone_number": "484-706-9465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 BRISTOL CT",
"city": "WYOMISSING",
"state": "PA",
"postal_code": "196101805",
"telephone_number": "484-706-9465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKERNAN",
"first_name": "KAILI",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-12",
"last_updated": "2024-08-16",
"certification_date": "2024-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "PA",
"license": "APC000258",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "483106300",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wyomissing, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.