Active NPI
Michael R. Kerschner, PSYD
- Psychologist
- Elyria, OH
National Provider Identifier
1659466175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 5418
- Practice address
- 936 Hartford Drive
Elyria, OH 44035 - Phone
- (440) 315-1859
- Fax
- (440) 365-5288
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 5418 | OH | Primary |
Addresses
Primary practice location
936 Hartford Drive
Elyria, OH 44035
Mailing address
936 Hartford Drive
Elyria, OH 44035
Phone (440) 315-1859
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2208620 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5418 | OH | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Psychologist | Current | Accepting new patients |
| Psychology Consultants Inc | Past | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
4449 Easton Way
Fl 2
Columbus, OH 43219
Phone (614) 565-8197
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/psychologyconsultantsinc/r4/
Organizations & group practices 3
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.
-
- Psychologist
- North Ridgeville, OH
- NPI 1821018698
-
- Clinical Social Worker
- Medina, OH
- NPI 1205882941
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1659466175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "936 HARTFORD DRIVE",
"city": "ELYRIA",
"state": "OH",
"postal_code": "44035",
"telephone_number": "440-315-1859",
"fax_number": "440-365-5288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "936 HARTFORD DRIVE",
"city": "ELYRIA",
"state": "OH",
"postal_code": "44035",
"telephone_number": "440-315-1859",
"fax_number": "440-365-5288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERSCHNER",
"first_name": "MICHAEL",
"middle_name": "R.",
"name_prefix": "Mr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "5418",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2208620",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elyria, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.