Individual provider Active NPI

Jeffrey K. Kerner, D.O.

  • General Practice Physician
  • New Castle, DE
National Provider Identifier
1275643967
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
C2-0002172 Issued in DE
Practice address
200 Bassett Ave
New Castle, DE 19720-1802
Phone
(302) 328-0669
Fax
(302) 328-8937
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X C2-0002172 DE Primary

Addresses

Primary practice location

200 Bassett Ave
New Castle, DE 19720-1802

Mailing address

200 Bassett Ave
New Castle, DE 19720-1802
Phone (302) 328-0669

Other identifiers 1

IdentifierTypeStateIssuer
0000036803MedicaidDE

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
C2-0002172DEMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1275643967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BASSETT AVE",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197201802",
            "telephone_number": "302-328-0669",
            "fax_number": "302-328-8937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BASSETT AVE",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197201802",
            "telephone_number": "302-328-0669",
            "fax_number": "302-328-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERNER",
        "first_name": "JEFFREY",
        "middle_name": "K.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "DE",
            "license": "C2-0002172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000036803",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Castle, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.