Individual provider Active NPI

Leah Kathyann Kernan, D.O.

  • Emergency Medicine Physician
  • Fort Hood, TX
National Provider Identifier
1639339302
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
P3015 Issued in TX
Practice address
BLDG 87008, 16TH St
Regimental Aid Station
Fort Hood, TX 76544
Phone
(254) 553-4126
NPI assigned
Jun 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X P3015 TX Primary
Emergency Medicine Physician 207P00000X 5101019536 MI

Addresses

Primary practice location

BLDG 87008, 16TH St
Regimental Aid Station
Fort Hood, TX 76544

Mailing address

PO Box 459
Holland, TX 76534-0459
Phone (254) 553-4126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130715000711 TX Practitioner - Emergency Medicine 0840430872 Reassigns benefits to 3 organizations
I20230802003507 MO Practitioner - Emergency Medicine 0840430872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians of Memphis LLCGroup PAC ID 5395643209, 92 clinicians

Practice addresses (Care Compare)

1101 W Liberty St
Parkland Health Center Farmington
Farmington, MO 63640-1921
Phone (573) 756-6451

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101019536MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Sep 25, 2018 Accepting new patients
Texas Emergency Group LLC Emergency Medicine CurrentSince Jun 1, 2022 Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine CurrentSince May 1, 2013 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Jun 13, 2023 Accepting new patients
The Emergency Clinic of Floresville, LLC Past Accepting new patients

Locations

7245 Raider Rd
Bonne Terre, MO 63628
Phone (573) 358-1400

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1101 W Liberty St
Farmington, MO 63640
Phone (573) 705-1272

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

2550 N Esplanade St
Cuero, TX 77954
Phone (361) 275-0532

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1639339302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "HOLLAND",
            "state": "TX",
            "postal_code": "765340459",
            "telephone_number": "254-553-4126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 87008, 16TH ST",
            "address_2": "REGIMENTAL AID STATION",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "254-553-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERNAN",
        "first_name": "LEAH",
        "middle_name": "KATHYANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "P3015",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101019536",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Hood, TX

Sources for this page

Verify at the official NPI Registry.