Kenneth Oliver Jerry, ARNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

11022086 Issued in FL

Practice address

13800 Veterans Way
Orlando, FL 32827-7401

Phone

(407) 631-3100

NPI assigned

Oct 18, 2022

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1124744560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14927 TWINBERRY DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287332",
            "telephone_number": "407-902-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 VETERANS WAY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277401",
            "telephone_number": "407-631-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERRY",
        "first_name": "KENNETH",
        "middle_name": "OLIVER",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11022086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Claire Jerome, LCSW
• Stephanie Jerome, PHD
• Jerry a Rubin MD
• Jerry Home Health, Inc.
• Angela Jerry
• Jesse Edwards DMD PLLC
• Laura Jessee, APRN
• Jessica Dean Consulting
• William R Jeter, MD
• Aalee Jethwani

• Gerontology Nurse Practitioner in Orlando, FL
• Providers in Orlando, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.