Active NPI
George Wallace Kernodle Jr., M.D.
- Rheumatology Physician
- Burlington, NC
National Provider Identifier
1609896794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 27474
- Practice address
- 1234 Huffman Mill Rd
Burlington, NC 27215-8700 - Phone
- (336) 538-1234
- Fax
- (336) 538-2390
- NPI assigned
- Jul 20, 2006
- Last updated
- Jan 30, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 27474 | NC | Primary |
Addresses
Primary practice location
1234 Huffman Mill Rd
Burlington, NC 27215-8700
Mailing address
PO Box 1717
Burlington, NC 27216-1717
Phone (336) 538-1234
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8948641 | Medicaid | NC |
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 |
|---|---|---|---|
| 27474 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359504000000",
"number": "1609896794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1717",
"city": "BURLINGTON",
"state": "NC",
"postal_code": "272161717",
"telephone_number": "336-538-1234",
"fax_number": "336-538-2390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1234 HUFFMAN MILL RD",
"city": "BURLINGTON",
"state": "NC",
"postal_code": "272158700",
"telephone_number": "336-538-1234",
"fax_number": "336-538-2390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERNODLE",
"first_name": "GEORGE",
"middle_name": "WALLACE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2013-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "NC",
"license": "27474",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8948641",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burlington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.