Jerry Keith Kubena Jr., MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A121373 Issued in CA

Practice address

515 28 3/4 Rd
Grand Junction, CO 81501-5016

Phone

(970) 263-4918

NPI assigned

Jun 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Contra Costa County

  • General Acute Care Hospital
  • Martinez, CA
  • NPI 1386719086
  NPD (past)

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1104023563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864300424",
            "telephone_number": "800-562-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 28 3/4 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815015016",
            "telephone_number": "970-263-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBENA",
        "first_name": "JERRY",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0057761",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A121373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristi a. Clukey, M.D., P.C.
• Brandi L Kroese
• Makenzie Kroupa, OTR/L
• April L Krutka, DO
• Alena Kryvanos
• John William Kuhn, DPT
• Ricki Kumar
• Karl M Kunstadter, DDS
• Joseph David Kuper
• Angela L Kurtz, MD

• Psychiatry Physician in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Psychiatry Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2017; 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.