Kerriann Mahon, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

47040 Issued in MN

Practice address

101 Willmar Ave SW
Affiliated Community Medical Centers
Willmar, MN 56201

Phone

(320) 231-5000

Fax

(320) 231-5067

NPI assigned

Dec 6, 2005

Last updated

Oct 14, 2022By the provider in NPPES

Sex

Female

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

Enrolled in MN

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mayo Clinic Health System-Southwest Minnesota Region

  dba Mayo Clinic Health System - Mankato

  • Multi-Specialty Clinic/Center
  • Mankato, MN
  • NPI 1578545422
  Medicare reassignment NPD
• Range Regional Health Services

  • Clinic/Center
  • Hibbing, MN
  • NPI 1669569265
  Medicare reassignment NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  dba Mayo Clinic Health System-Waseca

  • Multi-Specialty Clinic/Center
  • Waseca, MN
  • NPI 1518494251
  NPD
• Range Regional Health Services

  dba HealthLine Medical Supply

  • Durable Medical Equipment & Medical Supplies
  • International Falls, MN
  • NPI 1710954821
  NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  dba Mayo Clinic Health System - Mankato

  • General Acute Care Hospital
  • Mankato, MN
  • NPI 1154302487
  NPD (past)

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1144204819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "address_2": "AFFILIATED COMMUNITY MEDICAL CENTERS",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "56201",
            "telephone_number": "320-231-5000",
            "fax_number": "320-231-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "address_2": "AFFILIATED COMMUNITY MEDICAL CENTERS",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "56201",
            "telephone_number": "320-231-5000",
            "fax_number": "320-231-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHON",
        "first_name": "KERRIANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MN",
            "license": "47040",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "47040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lutheran Social Service of Minnesota
• Ashraf Hussein Maalin
• Melissa Ann Maas, PSYD LP
• Gregory M Macik, OD
• Taylor Madsen
• Alexandra Malkuch, CRNA
• James Malkuch, CRNA
• Ross Edwin Malkuch, CRNA
• Peter Joseph Mansur, LMFT
• Nicholas Jay Marcus, D.D.S.

• Pediatrics Physician in Willmar, MN
• Providers in Willmar, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.