Kerry Vaughn Rifkin, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

ME0041529 Issued in FL

Practice address

2140 Kingsley Ave
Suite 14
Orange Park, FL 32073-5180

Phone

(904) 276-7997

Fax

(904) 276-7559

NPI assigned

May 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Vascular Surgery Associates of N Florida, PA

  • Specialist
  • Orange Park, FL
  • NPI 1700853157
  NPD (past) Authorized official
• Acclaim Physician Group, Inc

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1780076562
  NPD

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1730134644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 KINGSLEY AVE",
            "address_2": "SUITE 14",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735180",
            "telephone_number": "904-276-7997",
            "fax_number": "904-276-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 KINGSLEY AVE",
            "address_2": "SUITE 14",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735180",
            "telephone_number": "904-276-7997",
            "fax_number": "904-276-7559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044917",
            "country_code": "US",
            "telephone_number": "817-702-3431",
            "fax_number": "817-927-3603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIFKIN",
        "first_name": "KERRY",
        "middle_name": "VAUGHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "G4046",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME0041529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067441900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "15764",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020016680",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna N Richardson, ARNP
• Alexandra Richetti
• Vanessa Richmond
• Kristine Lynn Ricks, ARNP
• Christina Ridinger
• Kimberlee Riggs, LMHC
• Shayla Riley-Dorsey
• Christina Riley
• River City Medicine LLC
• River City Primary & Urgent Care

• Vascular Surgery Physician in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Vascular Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.

Verify at the official NPI Registry.