Organization Active NPI

Kern County Medical Clinic,Inc.

  • Allergy & Immunology Physician
  • Bakersfield, CA
National Provider Identifier
1477698686
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
C41262 Issued in CA
Legal business name
KERN COUNTY MEDICAL CLINIC,INC.
Practice address
2222 19TH Street
Bakersfield, CA 93301
Phone
(661) 325-2448
Fax
(661) 325-7425
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Authorized official

Name
See Ruern Kitt, MDNPI 1710091749
Title
Physician
Phone
(661) 325-2448

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X C41262 CA Primary
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X C41262 CA

Addresses

Primary practice location

2222 19TH Street
Bakersfield, CA 93301

Mailing address

2222 19TH Street
Bakersfield, CA 93301
Phone (661) 325-2448

Other identifiers 3

IdentifierTypeStateIssuer
00C412620MedicaidCA
BS111AOtherMEDICARE PTAN
1710091749OtherCANPI PROVIDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090526000132 CA Part B Supplier - Clinic/Group Practice 1759430630 Receives reassigned benefits from 1 practitioner
Practice locations: Bakersfield, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1477698686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 19TH STREET",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93301",
            "telephone_number": "661-325-2448",
            "fax_number": "661-325-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 19TH STREET",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93301",
            "telephone_number": "661-325-2448",
            "fax_number": "661-325-7425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERN COUNTY MEDICAL CLINIC,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "KITT",
        "authorized_official_first_name": "SEE RUERN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "661-325-2448",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "C41262",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "C41262",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C412620",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BS111A",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI PROVIDER",
            "identifier": "1710091749",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.