Active NPI
Edward E Kern, MD
- Psychiatry Physician
- Opelika, AL
National Provider Identifier
1023074978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 10622
- Practice address
- 2202 Gateway Dr
A
Opelika, AL 36801-6870 - Phone
- (334) 745-6125
- Fax
- (334) 745-8102
- NPI assigned
- Apr 20, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 10622 | AL | Primary |
Addresses
Primary practice location
2202 Gateway Dr
A
Opelika, AL 36801-6870
Mailing address
3001 Scenic Highway
Gadsden, AL 35904-3047
Phone (256) 546-9265
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 515-22840 | Other | AL | BLUE CROSS OF AL PROV # |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10622 | AL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205366400000",
"number": "1023074978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 SCENIC HIGHWAY",
"city": "GADSDEN",
"state": "AL",
"postal_code": "359043047",
"telephone_number": "256-546-9265",
"fax_number": "256-549-0376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2202 GATEWAY DR",
"address_2": "A",
"city": "OPELIKA",
"state": "AL",
"postal_code": "368016870",
"telephone_number": "334-745-6125",
"fax_number": "334-745-8102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERN",
"first_name": "EDWARD",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-20",
"last_updated": "2008-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AL",
"license": "10622",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF AL PROV #",
"identifier": "515-22840",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Opelika, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.