Individual provider Active NPI

Joseph C Kerlin, MD

  • Family Medicine Physician
  • Danville, IN
National Provider Identifier
1801985700
Registry record updated Dec 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01019076 Issued in IN
Practice address
318 Northpointe CT
Danville, IN 46122-1067
Phone
(317) 409-9529
NPI assigned
Oct 11, 2006
Last updated
Dec 30, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01019076 IN Primary

Addresses

Primary practice location

318 Northpointe CT
Danville, IN 46122-1067

Mailing address

318 Northpointe CT
Danville, IN 46122-1067
Phone (317) 409-9529

Other identifiers 1

IdentifierTypeStateIssuer
100133200MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20090929000459 IN Practitioner - General PracticePractitioner - Family PracticePractitioner - Geriatric Medicine 5597675959 Reassigns benefits to 1 organization
Practice locations: Avon, IN; Indianapolis, IN; Danville, IN

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01019076INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patient Care Services Team CurrentSince Sep 16, 2014 Accepting new patients
Major Hospital Past Accepting new patients

Locations

3021 Stella Dr
#C
Greenwood, IN 46143
Phone (317) 409-9529

5865 Sugar Ln
Plainfield, IN 46168
Phone (317) 680-7999

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483056000000",
    "number": "1801985700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 NORTHPOINTE CT",
            "city": "DANVILLE",
            "state": "IN",
            "postal_code": "461221067",
            "telephone_number": "317-409-9529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 NORTHPOINTE CT",
            "city": "DANVILLE",
            "state": "IN",
            "postal_code": "461221067",
            "telephone_number": "317-409-9529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERLIN",
        "first_name": "JOSEPH",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2016-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01019076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100133200",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IN

Sources for this page

Verify at the official NPI Registry.