Individual provider Active NPI

John A Kermen, D.O.

  • Anesthesiology Physician
  • Fort Bragg, CA
National Provider Identifier
1306896428
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
20A6669 Issued in CA
Practice address
700 River Dr
Fort Bragg, CA 95437-5403
Phone
(707) 961-1234
NPI assigned
May 11, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 20A6669 CA Primary

Addresses

Primary practice location

700 River Dr
Fort Bragg, CA 95437-5403

Mailing address

PO Box 34120
Reno, NV 89533-4120
Phone (775) 747-5050

Other identifiers 1

IdentifierTypeStateIssuer
00AX66690MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050708000779 CA Practitioner - Anesthesiology 4385670629 Reassigns benefits to 3 organizations
Receives reassigned benefits from 3 practitioners
Practice locations: Fort Bragg, CA; Placerville, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
6669CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sonora Anesthesia Services a Medical Group Inc Anesthesiology CurrentSince May 5, 2024 Accepting new patients
Anesthesia Associates of Chico Anesthesiology CurrentSince Oct 9, 2023 Accepting new patients

Locations

121 Raley Blvd
Chico, CA 95928
Phone (530) 230-2000

1000 Greenley Rd
Sonora, CA 95370
Phone (209) 263-0803

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1306896428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34120",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895334120",
            "telephone_number": "775-747-5050",
            "fax_number": "775-747-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 RIVER DR",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375403",
            "telephone_number": "707-961-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERMEN",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "20A6669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX66690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, CA

Sources for this page

Verify at the official NPI Registry.