Individual provider Active NPI

Michael Louis Kerner, MD

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1417054057
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
9300184 Issued in NC
Practice address
14089 Collection Center Dr
Chicago, IL 60693-0140
Phone
(919) 479-9993
Fax
(919) 479-9996
NPI assigned
Sep 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 9300184 NC Primary

Addresses

Primary practice location

14089 Collection Center Dr
Chicago, IL 60693-0140

Mailing address

3901 N Roxboro St
Suite 701
Durham, NC 27704-2181
Phone (919) 479-9993

Other identifiers 1

IdentifierTypeStateIssuer
8948653MedicaidNC

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Sleep Centers, PLLC PastSince May 1, 2009 Accepting new patients
Atlantic Diagnostic Center PA Diagnostic Radiology Past Accepting new patients
University of North Carolina Hospitals at Chapel Hill Past Accepting new patients
Atlantic Diagnostic Center PA Diagnostic Radiology Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417054057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 N ROXBORO ST",
            "address_2": "SUITE 701",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042181",
            "telephone_number": "919-479-9993",
            "fax_number": "919-479-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14089 COLLECTION CENTER DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606930140",
            "telephone_number": "919-479-9993",
            "fax_number": "919-479-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERNER",
        "first_name": "MICHAEL",
        "middle_name": "LOUIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "9300184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8948653",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.