Matthew Brooks Kerner, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

0160002193 Issued in VT

Practice address

803 Pennsylvania Ave
Ste 302
Charleston, WV 25302

Phone

(304) 388-2950

Fax

(304) 388-2951

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1083709232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MORRIS ST",
            "address_2": "#107",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011821",
            "telephone_number": "304-344-2220",
            "fax_number": "304-388-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 PENNSYLVANIA AVE",
            "address_2": "STE 302",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25302",
            "telephone_number": "304-388-2950",
            "fax_number": "304-388-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERNER",
        "first_name": "MATTHEW",
        "middle_name": "BROOKS",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "0160002193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010666",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0160002193",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810009544",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Greta Kennett
• Kahliesha Taniece Kennings
• Erin Rae Kenny, PA-C
• Elizabeth J Kent, LICSW
• Joshua Ian Kepfinger, DO
• Fred T Kerns, M.D.
• Patrick L Kerr, PHD
• Sky Kershner, LPC , LCSW
• Amber Larae Kesling, LPN
• Kenneth Kesner

• Dentist in Charleston, WV
• Providers in Charleston, WV by specialty
• Dentist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.