Individual provider Active NPI

Kerry A Bron, MD

  • Pediatric Radiology Physician
  • Wilmington, DE
National Provider Identifier
1114076502
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
C10008764 Issued in DE
Practice address
1600 Rockland Road
Wilmington, DE 19803-3607
Phone
(302) 651-4000
Fax
(302) 651-4945
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MT029313 PA
Pediatric Radiology Physician 2085P0229X C10008764 DE Primary
Pediatric Radiology Physician 2085P0229X MD054174L PA
Pediatric Radiology Physician 2085P0229X ME111342 FL
Pediatric Radiology Physician 2085P0229X 25MA08485300 NJ

Addresses

Primary practice location

1600 Rockland Road
Wilmington, DE 19803-3607

Mailing address

PO Box 191
Rockland, DE 19723-0191
Phone (302) 651-6212

Other identifiers 4

IdentifierTypeStateIssuer
001528291MedicaidPA
4156935 00MedicaidMD
0173088MedicaidNJ
010336400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, NJ, FL3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20091112000193 DE Practitioner - Diagnostic RadiologyPractitioner - Pediatric Medicine 2961540984 Reassigns benefits to 1 organization
I20150317000068 NJ Practitioner - Diagnostic Radiology 2961540984 Reassigns benefits to 1 organization
I20150325001898 FL Practitioner - Diagnostic Radiology 2961540984 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT029313PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nemours New Jersey Physician Practice, P.C. CurrentSince Dec 27, 2014 Accepting new patients
The Nemours Foundation CurrentSince Jan 11, 2015 Accepting new patients
The Nemours Foundation CurrentSince Jan 22, 2019 Accepting new patients
The Nemours Foundation Current Accepting new patients
SCHC Pediatric Associates, LLC Past Accepting new patients

Locations

1600 Rockland Rd
Wilmington, DE 19803

401 Garasches Ln
Ste 120
Wilmington, DE 19801
Phone (302) 485-7010

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

1717 S Orange Ave
Ste 100
Orlando, FL 32806

1280 Almonesson Rd
Woodbury, NJ 08096
Phone (856) 345-1401

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1114076502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197230191",
            "telephone_number": "302-651-6212",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND ROAD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033607",
            "telephone_number": "302-651-4000",
            "fax_number": "302-651-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRON",
        "first_name": "KERRY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MT029313",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "DE",
            "license": "C10008764",
            "primary": true
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "PA",
            "license": "MD054174L",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "FL",
            "license": "ME111342",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "NJ",
            "license": "25MA08485300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001528291",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4156935 00",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0173088",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010336400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.