Individual provider Active NPI

Ida Mae Kerbs

  • Case Manager/Care Coordinator
  • Emporia, KS
National Provider Identifier
1063557924
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
2136 Morningside Dr
Emporia, KS 66801-5452
Phone
(620) 341-9682
Fax
(620) 345-1968
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X KS Primary

Addresses

Primary practice location

2136 Morningside Dr
Emporia, KS 66801-5452

Mailing address

2136 Morningside Drive
Emporia, KS 66801-5452
Phone (620) 341-9682

Other identifiers 1

IdentifierTypeStateIssuer
0886905701MedicaidKS

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

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1063557924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2136 MORNINGSIDE DRIVE",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668015452",
            "telephone_number": "620-341-9682",
            "fax_number": "620-345-1968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2136 MORNINGSIDE DR",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668015452",
            "telephone_number": "620-341-9682",
            "fax_number": "620-345-1968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERBS",
        "first_name": "IDA",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0886905701",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Emporia, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.