Individual provider Active NPI

Wendy S Kershner

  • Pediatric Nurse Practitioner
  • Kalamazoo, MI
National Provider Identifier
1386803013
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
4704172348 Issued in MI
Practice address
924 Russell St
Kalamazoo, MI 49001-3026
Phone
(269) 337-1702
NPI assigned
Jun 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 4704172348 MI Primary

Addresses

Primary practice location

924 Russell St
Kalamazoo, MI 49001-3026

Mailing address

359 Courtney
Galesburg, MI 49053-9694
Phone (269) 268-5716

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4704172348MIMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212710400000",
    "number": "1386803013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 COURTNEY",
            "city": "GALESBURG",
            "state": "MI",
            "postal_code": "490539694",
            "telephone_number": "269-268-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 RUSSELL ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490013026",
            "telephone_number": "269-337-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSHNER",
        "first_name": "WENDY",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704172348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.