Individual provider Active NPI

Howard B Kerwin, DO

  • Internal Medicine Physician
  • Clinton TWP, MI
National Provider Identifier
1134124209
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101008611 Issued in MI
Practice address
15520 19 Mile Rd
Ste 480
Clinton TWP, MI 48038-6332
Phone
(586) 228-1010
Fax
(586) 228-8570
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101008611 MI Primary

Addresses

Primary practice location

15520 19 Mile Rd
Ste 480
Clinton TWP, MI 48038-6332

Mailing address

15520 19 Mile Rd
Ste 480
Clinton TWP, MI 48038-6332
Phone (586) 228-1010

Other identifiers 2

IdentifierTypeStateIssuer
1155000615OtherMIBLUE CROSS/SHIELD MICHIGA
1999965MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101008611MIMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1134124209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15520 19 MILE RD",
            "address_2": "STE 480",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386332",
            "telephone_number": "586-228-1010",
            "fax_number": "586-228-8570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15520 19 MILE RD",
            "address_2": "STE 480",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386332",
            "telephone_number": "586-228-1010",
            "fax_number": "586-228-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERWIN",
        "first_name": "HOWARD",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101008611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/SHIELD MICHIGA",
            "identifier": "1155000615",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1999965",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

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