Individual provider Active NPI

Jill E. Kerr, D.O.

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1023018595
Registry record updated Jul 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3241 Issued in AZ
Practice address
4530 E Ray Rd
Suite 190
Phoenix, AZ 85044-6094
Phone
(480) 940-5420
Fax
(480) 940-5480
NPI assigned
Jul 27, 2005
Last updated
Jul 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3241 AZ Primary

Addresses

Primary practice location

4530 E Ray Rd
Suite 190
Phoenix, AZ 85044-6094

Mailing address

4530 E Ray Rd
Suite 190
Phoenix, AZ 85044-6094
Phone (480) 940-5420

Other identifiers 2

IdentifierTypeStateIssuer
264581170OtherFLOCEAN SHORE FAMILY MEDICAL CENTER
860950956OtherASTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040420000394 AZ Practitioner - Family Practice 3476445420 Reassigns benefits to 1 organization
I20240914000640 MO Practitioner - Family Practice 3476445420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 W Jefferson St
Kirksville, MO 63501-1443
Phone (660) 626-2304

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Good Health Medical, PLLC Family Medicine CurrentSince Jul 17, 2017 Accepting new patients
Good Health Medical, PLLC Family Medicine Current Accepting new patients
A T Still University of Health Sciences Family Medicine CurrentSince Aug 26, 2024 Accepting new patients
A T Still University of Health Sciences CurrentSince Aug 26, 2024 Accepting new patients
Good Health Medical, PLLC Family Medicine CurrentSince Jul 17, 2017 Accepting new patients
James Nichols MD, LTD. PastSince Sep 11, 2021 Accepting new patients
Jill E Kerr, D. O. P.C. Family Medicine PastSince Sep 1, 2003 Accepting new patients

Locations

261 N Roosevelt Ave
Chandler, AZ 85226
Phone (480) 305-2888

3100 N Alma School Rd
Chandler, AZ 85224
Phone (480) 255-5983

428 S Gilbert Rd
Ste 101
Gilbert, AZ 85296
Phone (480) 632-7400

1035 N Ellsworth Rd
Ste 108
Mesa, AZ 85207
Phone (480) 305-2888

1982 W Main St
Ste 101
Mesa, AZ 85201
Phone (480) 295-4880

2640 W Baseline Rd
Ste 111
Phoenix, AZ 85041
Phone 4803052888 ext. 1109

287 E Hunt Hwy
Ste 105
San Tan Valley, AZ 85143
Phone (480) 455-7444

800 W Jefferson St
Kirksville, MO 63501
Phone (660) 626-2235

800 W Jefferson St
Fl 1
Kirksville, MO 63501

Interoperability endpoints

  • Direct secure messaging: jill.kerr@atsu.directbygreenway.com
  • Direct secure messaging: jill.kerr@direct.elationemr.com

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499040000000",
    "number": "1023018595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 E RAY RD",
            "address_2": "SUITE 190",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446094",
            "telephone_number": "480-940-5420",
            "fax_number": "480-940-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 E RAY RD",
            "address_2": "SUITE 190",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446094",
            "telephone_number": "480-940-5420",
            "fax_number": "480-940-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "JILL",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-27",
        "last_updated": "2017-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "3241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCEAN SHORE FAMILY MEDICAL CENTER",
            "identifier": "264581170",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "860950956",
            "state": "AS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.