Jacob Kerbeshian, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

26652 Issued in MN

Practice address

111 Hundertmark Rd Ste 205N
Chaska, MN 55318-1586

Phone

(952) 903-1350

Fax

(952) 426-3856

NPI assigned

Sep 27, 2006

Last updated

Sep 15, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Family Support Services Inc.

  dba Sagent Behavioral Health

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD (past)
• Flagstaff Medical Center

  • General Acute Care Hospital
  • Flagstaff, AZ
  • NPI 1780635078
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1831280635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 ZANE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431814",
            "telephone_number": "763-762-8800",
            "fax_number": "763-315-6685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HUNDERTMARK RD STE 205N",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181586",
            "telephone_number": "952-903-1350",
            "fax_number": "952-426-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERBESHIAN",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MN",
            "license": "26652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Elizabeth Karn, M.D.
• Erin Jean Keech, PA-C
• Reed Keen, M.A.
• Erika Maricela Kennedy
• Kerber Psychological Services LLC
• Brenda Keske
• Eileen Marie Kirk, CPM
• Peter Marot Klinkenberg, DDS
• Lisa Ann Knudson, LICSW
• Elizabeth Koloc

• Child & Adolescent Psychiatry Physician in Chaska, MN
• Providers in Chaska, MN by specialty
• Child & Adolescent Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.