Active NPI
Philip Adolphe Kerne IV, PH.D.
- Counseling Psychologist
- Austin, TX
National Provider Identifier
1205097664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 33792
- Practice address
- 10505 S Ih 35
#732
Austin, TX 78747-2603 - Phone
- (512) 382-5410
- NPI assigned
- Jun 18, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 33792 | TX | Primary |
| Clinical Psychologist | 103TC0700X | 33792 | TX |
Addresses
Primary practice location
10505 S Ih 35
#732
Austin, TX 78747-2603
Mailing address
10505 S Ih 35
#732
Austin, TX 78747-2603
Phone (512) 382-5410
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33792 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351641600000",
"number": "1205097664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10505 S IH 35",
"address_2": "#732",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787472603",
"telephone_number": "512-382-5410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10505 S IH 35",
"address_2": "#732",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787472603",
"telephone_number": "512-382-5410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERNE",
"first_name": "PHILIP",
"middle_name": "ADOLPHE",
"name_prefix": "Dr.",
"name_suffix": "IV",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-18",
"last_updated": "2012-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "TX",
"license": "33792",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "33792",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.