Alan Robertson Kerr, PA-C, PSYD

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

105 S Stewart St
South Texas Rural Health Service
Cotulla, TX 78014

Phone

(830) 879-2502

NPI assigned

May 26, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1180137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1154532398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S STEWART ST",
            "address_2": "SOUTH TEXAS RURAL HEALTH SERVICE",
            "city": "COTULLA",
            "state": "TX",
            "postal_code": "78014",
            "telephone_number": "830-879-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S STEWART ST",
            "address_2": "SOUTH TEXAS RURAL HEALTH SERVICE",
            "city": "COTULLA",
            "state": "TX",
            "postal_code": "78014",
            "telephone_number": "830-879-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "ALAN",
        "middle_name": "ROBERTSON",
        "name_prefix": "Dr.",
        "credential": "PA-C, PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-26",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA06209",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "007203-1",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 9104943",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elizabeth Marie Lutz, LAT, ATC
• Celeste Pendaz Lyman, P.T.

• All providers in Cotulla, TX
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; 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.