Kerry Joe James, SA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

06-179 Issued in MO

Practice address

1398 Parkview Estates Dr
Ellisville, MO 63021-4643

Phone

(314) 392-3998

Fax

(618) 883-2849

NPI assigned

Jan 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cor Medical LLC

  • Durable Medical Equipment & Medical Supplies
  • Saint Louis, MO
  • NPI 1184080731
  NPD (past) Authorized official
• K&S Medical, L.L.C.

  • Surgical Physician Assistant
  • Ellisville, MO
  • NPI 1619114105
  NPD

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1235289240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1398 PARKVIEW ESTATES DR",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630214643",
            "telephone_number": "314-392-3998",
            "fax_number": "618-883-2849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1398 PARKVIEW ESTATES DR",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630214643",
            "telephone_number": "314-392-3998",
            "fax_number": "618-883-2849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "KERRY",
        "middle_name": "JOE",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "06-179",
            "primary": true
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "IL",
            "license": "238000599",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Winter Renae Husband
• Elizabeth Huxel
• Lawrence Bruce Iken, DPM
• Ivy Terrace at Gambrill Gardens III
• Jacqueline Hartman Inc
• Jay F. Hauser, DDS, PC
• Musadiq Jeddy, RPH
• Jeremy M Frith DDS
• Jodi Glaus Pingel, LLC
• John C Smith Jr Inc

• Surgical Physician Assistant in Ellisville, MO
• Providers in Ellisville, MO by specialty
• Surgical Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.