Individual provider Active NPI

Katherine Merry, M.D.

  • Internal Medicine Physician
  • Atlantis, FL
National Provider Identifier
1083147201
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME145946 Issued in FL
Practice address
180 JFK Dr
Suite 210
Atlantis, FL 33462-6641
Phone
(561) 548-1450
Fax
(561) 548-1459
NPI assigned
Apr 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X ME145946 FL Primary

Addresses

Primary practice location

180 JFK Dr
Suite 210
Atlantis, FL 33462-6641

Mailing address

180 John F Kennedy Dr
Atlantis, FL 33462-6641
Phone (561) 548-1450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210903000526 AK Practitioner - Internal Medicine 9931436300

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3701 E 112TH Ave
Anchorage, AK 99516-1434

5380 Tech Data Dr
Suite 101
Cleanwater, FL 33760-3122

Hospital & facility affiliations

  • Alaska Regional Hospital Hospital, Anchorage, AK, CCN 020017
  • Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME145946FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine of Ak, LLC CurrentSince Apr 1, 2023 Accepting new patients
Galen Hospital Alaska, Inc. Past Accepting new patients

Locations

2801 Debarr Rd
Anchorage, AK 99508
Phone (907) 264-1222

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1083147201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 JOHN F KENNEDY DR",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334626641",
            "telephone_number": "561-548-1450",
            "fax_number": "561-548-1459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 JFK DR",
            "address_2": "SUITE 210",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334626641",
            "telephone_number": "561-548-1450",
            "fax_number": "561-548-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRY",
        "first_name": "KATHERINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-05",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME145946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantis, FL

Sources for this page

Verify at the official NPI Registry.