Individual provider Active NPI

Desiree Clayton Lerch, PA

  • Physician Assistant
  • Largo, FL
National Provider Identifier
1063799377
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9106135 Issued in FL
Practice address
1945 E Bay Dr
Largo, FL 33771-2217
Phone
(727) 526-2771
Fax
(727) 584-4764
NPI assigned
Nov 15, 2011
Last updated
Nov 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 9106135 FL Primary

Addresses

Primary practice location

1945 E Bay Dr
Largo, FL 33771-2217

Mailing address

1945 E Bay Dr
Largo, FL 33771-2217
Phone (727) 526-2771

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 9106135FLMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1063799377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 E BAY DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337712217",
            "telephone_number": "727-526-2771",
            "fax_number": "727-584-4764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 E BAY DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337712217",
            "telephone_number": "727-526-2771",
            "fax_number": "727-584-4764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERCH",
        "first_name": "DESIREE",
        "middle_name": "CLAYTON",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-15",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9106135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.

Verify at the official NPI Registry.