Harrison Sherman Kuykendall III, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA11476 Issued in CA

Practice address

12550 Hesperia Road
Suite 100
Victorville, CA 92395-0000

Phone

(760) 241-6666

Fax

(760) 241-7575

NPI assigned

Mar 21, 2007

Last updated

Sep 10, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: harrisonkuykendall@vucdbaiuc.allscriptsdirect.net

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.

• Marque Medical Clinic, Inc.

  dba Marque Urgent Care, Inc.-Newport Beach

  • Urgent Care Clinic/Center
  • Newport Beach, CA
  • NPI 1538466107
  Medicare reassignment
• Inland Urgent Care a Medical Corporation

  dba Inland Urgent Care Corona

  • Urgent Care Clinic/Center
  • Corona, CA
  • NPI 1013369321
  NPD
• Marque Medical Clinic, Inc

  • Urgent Care Clinic/Center
  • Chula Vista, CA
  • NPI 1164303442
  NPD
• Vitality Urgent Care a Medical Corporation

  dba Inland Urgent Care

  • Urgent Care Clinic/Center
  • Temecula, CA
  • NPI 1649052218
  NPD

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1386760510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17095 MAIN ST",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923450000",
            "telephone_number": "760-241-6666",
            "fax_number": "760-241-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12550 HESPERIA ROAD",
            "address_2": "SUITE 100",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923950000",
            "telephone_number": "760-241-6666",
            "fax_number": "760-241-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUYKENDALL",
        "first_name": "HARRISON",
        "middle_name": "SHERMAN",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA11476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Kudrle
• Prashanth Vasantha Kumar, M.D.
• Ritesh Kumar, DDS
• Roberta Nolan Kunath, VN
• Trenisha Kunzi
• Jin Hee Kwon, D.C.
• Kyle J. Schell, O.D., Inc.
• Alyssa Ann La Curan
• La Pain and Performance
• William Eric Ladd

• Physician Assistant in Victorville, CA
• Providers in Victorville, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.