Active NPI
Kerry B Carr, FNP
- Nurse Practitioner
- Jackson, WY
National Provider Identifier
1285716746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 16888.0735
- Practice address
- 625 E Broadway Ave
Jackson, WY 83001-8642 - Phone
- (307) 739-6195
- Fax
- (307) 739-7229
- NPI assigned
- Oct 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 16888.0735 | WY | Primary |
Addresses
Primary practice location
625 E Broadway Ave
Jackson, WY 83001-8642
Mailing address
PO Box 428
Oncology Department
Jackson, WY 83001-0428
Phone (307) 739-6195
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 121883200 | Medicaid | WY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kcarr@sjmc.cernerdirect.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
625 E Broadway Ave
Jackson, WY 83001-8642
Phone (307) 733-3636
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.82 of 100
- Quality
- 67.1
- Promoting interoperability
- 98
- Improvement activities
- 40
- Cost
- 73.98
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kerry Carr Integrative Mental Health | Current | Accepting new patients | |
| Teton County Hospital District | Current | Accepting new patients |
Interoperability endpoints
- kcarr@sjmc.cernerdirect.com
Organizations & group practices 2
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.
-
dba St John's Health
- General Practice Physician
- Jackson, WY
- NPI 1487818605
-
- Psychiatric/Mental Health Nurse Practitioner
- Jackson, WY
- NPI 1407792211
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St John's Medical Center/ or St John's Health
- General Acute Care Hospital
- Jackson, WY
- NPI 1801835475
-
dba Eastern Idaho Regional Medical Center
- General Acute Care Hospital
- Idaho Falls, ID
- NPI 1225082209
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611360000000",
"number": "1285716746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 428",
"address_2": "ONCOLOGY DEPARTMENT",
"city": "JACKSON",
"state": "WY",
"postal_code": "830010428",
"telephone_number": "307-739-6195",
"fax_number": "307-739-7229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 E BROADWAY AVE",
"city": "JACKSON",
"state": "WY",
"postal_code": "830018642",
"telephone_number": "307-739-6195",
"fax_number": "307-739-7229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARR",
"first_name": "KERRY",
"middle_name": "B",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-20",
"last_updated": "2021-01-23",
"certification_date": "2021-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WY",
"license": "16888.0735",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "121883200",
"state": "WY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kcarr@sjmc.cernerdirect.com",
"affiliation": "N",
"endpointDescription": "Direct Messaging Address for St John's Health",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Other",
"address_1": "625 E Broadway Ave",
"city": "Jackson",
"state": "WY",
"country_code": "US",
"postal_code": "830018642",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Jackson, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.