Bonnie Jean Kerr, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G65305 Issued in CA

Practice address

3883 Airway Dr Ste 203
Santa Rosa, CA 95403

Phone

(707) 521-7760

Fax

(707) 521-7759

NPI assigned

Aug 31, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00155

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.

• Huntington Dermatology Medical Group Inc

  dba Dynasty Dermatology

  • Dermatology Physician
  • Pasadena, CA
  • NPI 1275664435

  Specialist

  NPD
• Sutter Bay Medical Foundation

  dba Palo Alto Medial Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1235241548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "707-521-7760",
            "fax_number": "707-521-7759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3883 AIRWAY DR STE 203",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95403",
            "telephone_number": "707-521-7760",
            "fax_number": "707-521-7759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Fairmount Ave",
            "address_2": "suite 425",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911053150",
            "country_code": "US",
            "telephone_number": "626-449-9992",
            "fax_number": "626-449-4504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERR",
        "first_name": "BONNIE",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-07",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G65305",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G65305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "G65305",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keri Gnanashanmugam Licensed Clinical Social Worker Inc. (Root Psychotherapy)
• Katie Jo Keridan, PSY.D.
• Leah Eichenholz Kermish-Wells, LMFT
• Keila Marina Kerns
• Allan Kerr
• Stacey Marie Kerr, M.D.
• Brittany Marie Kesler, LCSW
• William Andrew Kesler, D.P.T.
• Michael Charles Christian Kessler
• Roberta P Kestler, DC

• Dermatology Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.