Kelly Lee McKerahan, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A6780 Issued in CA

Practice address

25095 Jefferson Ave Ste 202
Murrieta, CA 92562-9107

Phone

(951) 696-9566

Fax

(951) 696-9536

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Family Practice

Education

Ohio University, College of Osteopathic Medicine, 1992

Medicare assignment

May accept Medicare assignment

Group practices

United Medical DoctorsGroup PAC ID 2961305651, 168 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9170/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/HGIFAA/Endpoint/HGIFAA

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.

• Kelly L McKerahan D O a Professional Medical Corporation

  • Primary Care Clinic/Center
  • Murrieta, CA
  • NPI 1508110503
  Medicare reassignment NPD Authorized official
• United Medical Doctors

  • Gastroenterology Physician
  • Murrieta, CA
  • NPI 1770559981
  Medicare reassignment Care Compare group NPD
• Rancho Family Medical Group, Inc.

  • Family Medicine Physician
  • Temecula, CA
  • NPI 1598791600
  Medicare reassignment NPD
• United Medical Doctors

  • Orthopaedic Surgery Physician
  • San Diego, CA
  • NPI 1194554675
  NPD

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1184705790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25095 JEFFERSON AVE",
            "address_2": "SUITE 202",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629113",
            "telephone_number": "951-696-9566",
            "fax_number": "951-696-9536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25095 JEFFERSON AVE STE 202",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629107",
            "telephone_number": "951-696-9566",
            "fax_number": "951-696-9536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKERAHAN",
        "first_name": "KELLY",
        "middle_name": "LEE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "GQ215Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler Philip McGee
• Andrea Jo McGowan
• Robert Pennington McGraw III, MD
• Brenda McGregor, LMFT, PSYD
• Regina Deloris McGuire
• Sally McKinley
• Melissa McKinzie
• Michael McLaughlin
• Sarah McLaughlin
• Deborah Marie McLendon

• Family Medicine Physician in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.