Individual provider Active NPI

Carol G Kercher, CRNP

  • Family Nurse Practitioner
  • Ashtabula, OH
National Provider Identifier
1063470102
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP27241 Issued in OH
Practice address
1230 Lake Ave
Ashtabula, OH 44004-2932
Phone
(440) 964-2218
Fax
(440) 964-8067
NPI assigned
May 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP27241 OH Primary

Addresses

Primary practice location

1230 Lake Ave
Ashtabula, OH 44004-2932

Mailing address

1230 Lake Ave
Ashtabula, OH 44004-2932
Phone (440) 964-2218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121221000320 PA Order and Referring Only - Nurse Practitioner 7517038623

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NP27241OHMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1063470102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440042932",
            "telephone_number": "440-964-2218",
            "fax_number": "440-964-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440042932",
            "telephone_number": "440-964-2218",
            "fax_number": "440-964-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERCHER",
        "first_name": "CAROL",
        "middle_name": "G",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "NP27241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

Verify at the official NPI Registry.