NPIMap

Individual provider Active NPI

Audrey J. Kerr, PA-C

  • Physician Assistant
  • Glendive, MT
National Provider Identifier
1790792836
Registry record updated Feb 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
641 Issued in MT
Practice address
202 Prospect Dr
Glendive, MT 59330-1943
Phone
(406) 345-3314
Fax
(406) 345-3324
NPI assigned
Aug 2, 2006
Last updated
Feb 2, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1233 NE
Physician Assistant 363A00000X 641 MT Primary

Addresses

Primary practice location

202 Prospect Dr
Glendive, MT 59330-1943

Mailing address

202 Prospect Dr
Glendive, MT 59330-1943
Phone (406) 345-3314

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110413000571 MT Practitioner - Physician Assistant 1355365057 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gabert Medical Services IncGroup PAC ID 2668385402, 23 clinicians
Glendive Medical Center IncGroup PAC ID 7214846823, 16 clinicians

Practice addresses (Care Compare)

107 Dilworth St
Glendive, MT 59330-2053
Phone (406) 345-8901

202 Prospect Dr
Glendive, MT 59330-1943
Phone (406) 345-3306

202 Prospect Dr
Glendive, MT 59330-1999

710 Drake St
Wibaux, MT 59353-9086
Phone (406) 796-4325

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
971NEMDOccupational Therapist
641MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Glendive Medical Center, Inc CurrentSince Jan 6, 2011 Accepting new patients
Glendive Medical Center, Inc CurrentSince Jan 6, 2011 Accepting new patients
Glendive Medical Center, Inc Current Accepting new patients
Box Butte General Hospital Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

107 Dilworth St
Glendive, MT 59330
Phone (406) 345-8900

202 Prospect Dr
Glendive, MT 59330
Phone (406) 345-3306

Interoperability endpoints

  • Direct secure messaging: akerr@gmc.cernerdirect.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391299200000",
    "number": "1790792836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 PROSPECT DR",
            "city": "GLENDIVE",
            "state": "MT",
            "postal_code": "593301943",
            "telephone_number": "406-345-3314",
            "fax_number": "406-345-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 PROSPECT DR",
            "city": "GLENDIVE",
            "state": "MT",
            "postal_code": "593301943",
            "telephone_number": "406-345-3314",
            "fax_number": "406-345-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "AUDREY",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2014-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1233",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendive, MT

Sources for this page

Verify at the official NPI Registry.