Individual provider Active NPI

Kerri Lynn Kroh, PA-C

  • Medical Physician Assistant
  • Pine Grove, PA
National Provider Identifier
1063746782
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA054153 Issued in PA
Practice address
8 Oak Grove Rd
Pine Grove, PA 17963-1226
Phone
(570) 345-3321
NPI assigned
Sep 28, 2009
Last updated
Mar 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA054153 PA Primary
Medical Physician Assistant 363AM0700X OA002406 PA

Addresses

Primary practice location

8 Oak Grove Rd
Pine Grove, PA 17963-1226

Mailing address

8 Oak Grove Rd
Ste 1
Pine Grove, PA 17963-1226

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
I20091119000543 PA Practitioner - Physician Assistant 1951440544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrated Medical Group P CGroup PAC ID 1355247180, 105 clinicians

Practice addresses (Care Compare)

420 S Jackson St
Pottsville, PA 17901-3625
Phone (570) 621-5000

48 Tunnel Rd
Pottsville, PA 17901-3875

8 Oak Grove Rd
Suite 1
Pine Grove, PA 17963-1226
Phone (570) 345-3321

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA054153PAMDMedical Physician Assistant
OA002406PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Group P C CurrentSince Mar 17, 2017 Accepting new patients
Integrated Medical Group, P.C. CurrentSince Mar 17, 2017 Accepting new patients

Locations

8 Oak Grove Rd
Ste 1
Pine Grove, PA 17963
Phone (570) 345-3321

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

48 Tunnel Rd
Ste 104
Pottsville, PA 17901
Phone (570) 622-5555

82 Tunnel Rd
Pottsville, PA 17901
Phone (570) 622-5455

Interoperability endpoints

  • Direct secure messaging: kkroh@imgpc.medentdirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1063746782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 OAK GROVE RD",
            "address_2": "STE 1",
            "city": "PINE GROVE",
            "state": "PA",
            "postal_code": "179631226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 OAK GROVE RD",
            "city": "PINE GROVE",
            "state": "PA",
            "postal_code": "179631226",
            "telephone_number": "570-345-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROH",
        "first_name": "KERRI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA054153",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA002406",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Grove, PA

Sources for this page

Verify at the official NPI Registry.