Individual provider Active NPI

Sheri Larae McKernan, LMP

  • Specialist
  • Kelso, WA
National Provider Identifier
1912349150
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA60250659 Issued in WA
Practice address
206 Virginia St
Kelso, WA 98626-1426
Phone
(360) 433-1302
NPI assigned
Jul 29, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA60250659 WA Primary

Addresses

Primary practice location

206 Virginia St
Kelso, WA 98626-1426

Mailing address

206 Virginia St
Kelso, WA 98626-1426
Phone (360) 433-1302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA60250659WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1912349150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 VIRGINIA ST",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986261426",
            "telephone_number": "360-433-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 VIRGINIA ST",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986261426",
            "telephone_number": "360-433-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKERNAN",
        "first_name": "SHERI",
        "middle_name": "LARAE",
        "name_prefix": "Ms.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-29",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA60250659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kelso, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.