Individual provider Active NPI

Keri L Bourdage, PA-C

  • Physician Assistant
  • Gainesville, FL
National Provider Identifier
1588603443
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9103318 Issued in FL
Practice address
6420 W Newberry Rd Ste 100
Gainesville, FL 32605-6622
Phone
(352) 332-3900
Fax
(352) 332-5009
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9103318 FL Primary

Addresses

Primary practice location

6420 W Newberry Rd Ste 100
Gainesville, FL 32605-6622

Mailing address

PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200

Other identifiers 1

IdentifierTypeStateIssuer
292626100MedicaidFL

Other names 1

  • Kerl Lynn Bourdage Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050919000014 FL Practitioner - Physician Assistant 4284667312 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Jan 5, 2026 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Feb 21, 2011 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Feb 21, 2011 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC Past Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

6420 W Newberry Rd
Ste 100WING
Gainesville, FL 32605

6420 W Newberry Rd
Ste 100
Gainesville, FL 32605
Phone (352) 332-3900

4945 SW 49th Pl
Ocala, FL 34474
Phone (352) 237-9430

1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780

4420 Sun N Lake Blvd
Fl Cancer
Sebring, FL 33872
Phone (863) 385-1244

1400 N US Highway 441
Ste 540
The Villages, FL 32159
Phone (352) 561-3290

Interoperability endpoints

  • Direct secure messaging: kbourdage7356@direct.shands.ufl.edu

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1588603443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 W NEWBERRY RD STE 100",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326056622",
            "telephone_number": "352-332-3900",
            "fax_number": "352-332-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURDAGE",
        "first_name": "KERI",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292626100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERL",
            "last_name": "BOURDAGE",
            "middle_name": "LYNN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.