Active NPI
Bernard Perkins Kemker Jr., MD
- Specialist
- Jasper, IN
National Provider Identifier
1467429043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 01039177
- Practice address
- 712 W 13TH St
Jasper, IN 47546-1816 - Phone
- (812) 482-4494
- NPI assigned
- Mar 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 01039177 | IN | |
| Specialist | 174400000X | 01039177 | IN | Primary |
Addresses
Primary practice location
712 W 13TH St
Jasper, IN 47546-1816
Mailing address
712 W 13TH St
Suite 220
Jasper, IN 47546-1816
Phone (812) 482-4494
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000220291 | Other | IN | ANTHEM BLUE CROSS |
| 000000220291 | Other | IN | ANTHEM |
| 100110880 | Medicaid | IN | |
| CJ8820 | Other | IN | MEDICARE RAILROAD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01039177 | IN | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jasper Surgical Associates | Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Surgery Physician
- Jasper, IN
- NPI 1073730834
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256169600000",
"number": "1467429043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "712 W 13TH ST",
"address_2": "SUITE 220",
"city": "JASPER",
"state": "IN",
"postal_code": "475461816",
"telephone_number": "812-482-4494",
"fax_number": "812-482-4499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "712 W 13TH ST",
"city": "JASPER",
"state": "IN",
"postal_code": "475461816",
"telephone_number": "812-482-4494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEMKER",
"first_name": "BERNARD",
"middle_name": "PERKINS",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-02",
"last_updated": "2009-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IN",
"license": "01039177",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IN",
"license": "01039177",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "000000220291",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000220291",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100110880",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "CJ8820",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jasper, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.