Stacey Marie Kerr, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G069395 Issued in CA

Practice address

3344 Cypress Way
Santa Rosa, CA 95405-7514

Phone

(707) 526-2540

NPI assigned

Sep 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083713473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3344 CYPRESS WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057514",
            "telephone_number": "707-526-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3344 CYPRESS WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057514",
            "telephone_number": "707-526-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "STACEY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G069395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Jo Keridan, PSY.D.
• Leah Eichenholz Kermish-Wells, LMFT
• Keila Marina Kerns
• Allan Kerr
• Bonnie Jean Kerr, M.D.
• Brittany Marie Kesler, LCSW
• William Andrew Kesler, D.P.T.
• Michael Charles Christian Kessler
• Roberta P Kestler, DC
• Myles Julian Ketchum, M.D., PH.D.

• Family Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.