Beth Christine Kerneklian, PTA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

91105 Issued in FL

Practice address

8936 77TH Ter E Unit 101
Lakewood Ranch, FL 34202-6419

Phone

(941) 758-7300

NPI assigned

Aug 20, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Beth Christine Taylor Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: beth.kerneklian.p2@direct.painreliefcenters.nextgenshare.com

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

• Tampa Pain Relief Center, Inc.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Tampa, FL
  • NPI 1871543751
  Medicare reassignment

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1073760146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8936 77TH TER E UNIT 101",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342026419",
            "telephone_number": "941-758-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8936 77TH TER E UNIT 101",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342026419",
            "telephone_number": "941-758-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "842 Sunset Lake Blvd Ste 303",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "FL",
            "postal_code": "342927552",
            "country_code": "US",
            "telephone_number": "941-488-5224",
            "fax_number": "941-893-3282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERNEKLIAN",
        "first_name": "BETH",
        "middle_name": "CHRISTINE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-20",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA. 05235",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "91105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "TAYLOR",
            "middle_name": "CHRISTINE",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Keen-Ramirez, DDS
• Stephanie Kelley
• Krista Kelly
• Kimberly F Kempton
• Mary Kennedy
• Ashley Donelle Ahlquist Kessler, DO
• Hannah Fareen Khan
• Arun P Khazanchi, MD
• Kids First Pediatrics
• Laura Elizabeth Kiely, PA

• Physician Assistant in Lakewood Ranch, FL
• Providers in Lakewood Ranch, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.