Active NPI
Jerry Kinder, MD
- Surgery Physician
- Cape Girardeau, MO
National Provider Identifier
1053362079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 27632
- Practice address
- 211 Saint Francis Dr
Cape Girardeau, MO 63703-5049 - Phone
- (573) 331-5330
- Fax
- (573) 331-5025
- NPI assigned
- May 15, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 27632 | MO | Primary |
| Internal Medicine Physician | 207R00000X | 27632 | MO |
Addresses
Primary practice location
211 Saint Francis Dr
Cape Girardeau, MO 63703-5049
Mailing address
PO Box 843225
Kansas City, MO 64184-3225
Phone (708) 633-1234
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0470659087 | Medicaid | IL | |
| 200015915 | Medicaid | MO | |
| 440912 | Other | HEALTHLINK | |
| 026299 | Other | MO | BCBS |
| 64068836 | Medicaid | KY | |
| 020053866 | Other | RR MEDICARE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305590400000",
"number": "1053362079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 843225",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641843225",
"telephone_number": "708-633-1234",
"fax_number": "708-342-7100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 SAINT FRANCIS DR",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637035049",
"telephone_number": "573-331-5330",
"fax_number": "573-331-5025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINDER",
"first_name": "JERRY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-15",
"last_updated": "2011-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MO",
"license": "27632",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "27632",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0470659087",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200015915",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "440912",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "026299",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64068836",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "020053866",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Cape Girardeau, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.