Individual provider Active NPI

Jason Kerska, PHARM. D

  • Pharmacist
  • Superior, WI
National Provider Identifier
1013249168
Registry record updated Mar 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15691-40 Issued in WI
Practice address
2015 Tower Ave
Superior, WI 54880-2538
Phone
(715) 392-9550
NPI assigned
Jan 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 119255 MN
Pharmacist 183500000X 15691-40 WI Primary

Addresses

Primary practice location

2015 Tower Ave
Superior, WI 54880-2538

Mailing address

2015 Tower Ave
Superior, WI 54880-2538

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
119255MNMDPharmacist
15691-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1264809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331337600000",
    "number": "1013249168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 TOWER AVE",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548802538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 TOWER AVE",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548802538",
            "telephone_number": "715-392-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSKA",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "PHARM. D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-30",
        "last_updated": "2012-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "119255",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "15691-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Superior, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.