Myra Susan Kersey, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R65618 Issued in AR

Practice address

836 N Division St
Forrest City, AR 72335-2708

Phone

(870) 633-1795

Fax

(870) 261-1818

NPI assigned

Oct 22, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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.

• Forrest City School District

  • Local Education Agency (LEA)
  • Forrest City, AR
  • NPI 1689734030
  NPD (past)

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288137600000",
    "number": "1316247448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 N DIVISION ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352708",
            "telephone_number": "870-633-1795",
            "fax_number": "870-261-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 N DIVISION ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352708",
            "telephone_number": "870-633-1795",
            "fax_number": "870-261-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSEY",
        "first_name": "MYRA",
        "middle_name": "SUSAN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AR",
            "license": "R65618",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R65618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124245761",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• K Michelle Imboden, DDS,PC
• Kah Development 4, LLC
• Chelsea Kellow-Foister, APN
• Walter Kendrick, MHPP
• Megan Kerley
• Kids for the Future of Forrest City, Inc.
• Kids for the Future of Forrest City, Inc.
• Kids for the Future Therapy Group, Inc.
• Kids for the Future, Inc.
• Kids for the Future, Inc.

• All providers in Forrest City, AR
• Registered Nurse in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; 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.