Mark J. Kernan, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

029908 Issued in WI

Practice address

620 W Brown St
Waupun, WI 53963-1702

Phone

(920) 324-5581

Fax

(920) 926-8370

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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.

• Mid West Anesthesia Consultants LLC

  • Certified Registered Nurse Anesthetist
  • Sterling, CO
  • NPI 1558327056

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Poplar Bluff Regional Medical Center LLC

  • General Acute Care Hospital
  • Poplar Bluff, MO
  • NPI 1700831724

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1609953157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-8332",
            "fax_number": "920-926-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W BROWN ST",
            "city": "WAUPUN",
            "state": "WI",
            "postal_code": "539631702",
            "telephone_number": "920-324-5581",
            "fax_number": "920-926-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERNAN",
        "first_name": "MARK",
        "middle_name": "J.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "029908",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "138",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "111617",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43331900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roman Yakov Kaplan, MD
• Elizabeth Ann Kartechner, APNP
• Thomas Katz, DDS
• Rebecca Jane Kehoe, PHARMD
• Jane Marie Kelsey, RPH
• Andrew Jay Kessler, M.D.
• Peggy L Keuler, NP
• Kaye Koehoorn
• Gail Ann Krummen-Lee, PMHNP-BC
• Kazoua Kue

• Certified Registered Nurse Anesthetist in Waupun, WI
• Providers in Waupun, WI by specialty
• Certified Registered Nurse Anesthetist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.