Organization Active NPI

Joshua Kershen MD PC

  • Neurology Physician
  • Oklahoma City, OK
National Provider Identifier
1063733954
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
21739 Issued in OK
Legal business name
JOSHUA KERSHEN MD PC
Practice address
4221 S Western Ave
5000
Oklahoma City, OK 73109-3447
Phone
(405) 644-5160
Fax
(405) 644-5162
NPI assigned
Jun 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Authorized official

Name
Joshua Colgrove Kershen, MDNPI 1770521064
Title
Physician
Phone
(405) 644-5160

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 21739 OK Primary

Addresses

Primary practice location

4221 S Western Ave
5000
Oklahoma City, OK 73109-3447

Mailing address

4221 S Western Ave
5000
Oklahoma City, OK 73109-3447
Phone (405) 644-5160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100916000132 OK Part B Supplier - Clinic/Group Practice 0345365268 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

4221 S Western Ave
Ste 5000
Oklahoma City, OK 73109
Phone (405) 644-5160

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437523200000",
    "number": "1063733954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 S WESTERN AVE",
            "address_2": "5000",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093447",
            "telephone_number": "405-644-5160",
            "fax_number": "405-644-5162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 S WESTERN AVE",
            "address_2": "5000",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093447",
            "telephone_number": "405-644-5160",
            "fax_number": "405-644-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSHUA KERSHEN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-15",
        "last_updated": "2015-07-22",
        "status": "A",
        "authorized_official_last_name": "KERSHEN",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "COLGROVE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "405-644-5160",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OK",
            "license": "21739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.