Kerry Dean Vance, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2012025753 Issued in MO

Practice address

2500 S Woodworth Loop
Palmer, AK 99645-8984

Phone

(907) 375-3355

Fax

(907) 375-3351

NPI assigned

Apr 5, 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 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• East Texas Clinic of Chiropractic, LLC

  • Chiropractor
  • Pittsburg, TX
  • NPI 1316593551
  NPD (past)
• East Texas Medical Center Healthcare Associates

  • Emergency Medicine Physician
  • Tyler, TX
  • NPI 1326082892
  NPD (past)
• Hood Chiropractic & Wellness Center PC

  • Chiropractor
  • Flint, TX
  • NPI 1568561991
  NPD (past)

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491609600000",
    "number": "1699737692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 B ST STE 200",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995035933",
            "telephone_number": "907-375-3355",
            "fax_number": "907-375-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S WOODWORTH LOOP",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996458984",
            "telephone_number": "907-375-3355",
            "fax_number": "907-375-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "KERRY",
        "middle_name": "DEAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2017-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H5367",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2012025753",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "7596",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1314130-08",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "8U1465",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "8CD653",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "1314130-09",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131413010",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valley Pediatric Dentistry
• Valley Radiation Oncology
• Valley Surgical Associates, Inc
• Lorri Ann Van Diest, LPC
• Trevor Van Oostrom, M.D.
• Erin Velander
• Daniel Mark Venhaus, PTA
• Sonia M Vent, PHYSICIAN ASSISTANT
• Victoria Vigue, PT, DPT, CLT
• Jennifer Gail Vinette, APRN

• Family Medicine Physician in Palmer, AK
• Providers in Palmer, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.