Kerry L Mayhew, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10001928 Issued in WA

Practice address

1007 Koala Ave
Omak, WA 98841-9247

Phone

(509) 826-8443

NPI assigned

Aug 20, 2006

Last updated

Dec 11, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1235244096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 HAUSSLER RD",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419591",
            "telephone_number": "509-826-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 KOALA AVE",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419247",
            "telephone_number": "509-826-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYHEW",
        "first_name": "KERRY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10001928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "127522",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003797",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler James Martin
• Jazmine Michelle Martinez
• Eric Cy Mathison, CRNA
• Russell Franklin Matthynssens, CPC
• Victoria Maxey
• Ronald McCluskey, DO
• Anton Stuart McCourtie, MD
• John McDonald, MHCP, RECOVERY COACH
• Meaghan Hope McElderry
• Bailey McGee, FNP

• Physician Assistant in Omak, WA
• Providers in Omak, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.