Andre T Kerr, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9111059 Issued in FL

Practice address

1330 SE 4TH Ave Ste B
Fort Lauderdale, FL 33316

Phone

(954) 463-3804

Fax

(954) 463-3805

NPI assigned

Feb 28, 2018

Last updated

Jul 31, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1093217648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 SE 4TH AVE STE B",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161958",
            "telephone_number": "954-463-3804",
            "fax_number": "954-463-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 SE 4TH AVE STE B",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33316",
            "telephone_number": "954-463-3804",
            "fax_number": "954-463-3805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "ANDRE",
        "middle_name": "T",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-28",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth H Farrell M.D. PA
• Amy Kenney, LCSW
• Barbara L Kenney, CRNA
• Kensho Wellness Group, LLC.
• Glen Kenyon
• Matthew James Kerr, RD
• Kerrianne Bresnan, Psy.D., LLC
• Kevin J Kessler, MD
• Phylice Kessler, LMHC
• Steven Gary Kessler, MD

• Physician Assistant in Fort Lauderdale, FL
• Providers in Fort Lauderdale, 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 31, 2019; 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.