Shawn Jeremy Kern

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

Underwater Construction Team 2 Medical
4643 Dock Road BLDG 524
Port Hueneme, CA 93043-0001

Phone

(805) 982-2464

Fax

(805) 982-3246

NPI assigned

Sep 14, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Underwater Construction Team Two

  • Military or U.S. Coast Guard Ground Transport Ambulance
  • Port Hueneme, CA
  • NPI 1881952661
  NPD (past)

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189728000000",
    "number": "1396930129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNDERWATER CONSTRUCTION TEAM 2 MEDICAL",
            "address_2": "4643 DOCK ROAD BLDG 524",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "930430001",
            "telephone_number": "805-982-2464",
            "fax_number": "805-982-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNDERWATER CONSTRUCTION TEAM 2 MEDICAL",
            "address_2": "4643 DOCK ROAD BLDG 524",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "930430001",
            "telephone_number": "805-982-2464",
            "fax_number": "805-982-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERN",
        "first_name": "SHAWN",
        "middle_name": "JEREMY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-14",
        "last_updated": "2007-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gyutae Jin, DMD
• Fernando Juarez, OTHER
• Piotor Juchniewicz, IDC
• Jason Jung, DO
• K J Shah DDS, Inc.
• Timothy J. Kerr, DIVE IDC
• Erik Christian Ketelsen, IDC
• James A Kirk, MPT
• Ryan Kitchens
• Roger Howard Knight, D.C.

• Independent Duty Corpsman in Port Hueneme, CA
• Providers in Port Hueneme, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; 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.