Kerry L Kole, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

5101012055 Issued in MI

Practice address

1105 Sixth St
Traverse City, MI 49684

Phone

(231) 935-7514

NPI assigned

Oct 20, 2005

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

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

General SurgeryAlso: Critical Care (Intensivists)

Education

Michigan State University College of Osteopathic Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Munson Medical Center 377 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Medical Center Hospital, Traverse City, MI, CCN 230097
• Munson Healthcare Otsego Memorial Hospital Hospital, Gaylord, MI, CCN 230133
• Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkole86377@direct.beaumont.edu
• Direct secure messaging: kkole2@direct.mhc.net

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.

• Munson Medical Center

  • Endocrinology, Diabetes & Metabolism Physician
  • Traverse City, MI
  • NPI 1083761860

  MI

  Medicare reassignment Care Compare group NPD
• Critical Care Surgeons PLLC

  • Trauma Surgery Physician
  • Detroit, MI
  • NPI 1710213731

  MI

  Medicare reassignment NPD
• Munson Healthcare Grayling

  • Rural Health Clinic/Center
  • Roscommon, MI
  • NPI 1710383351

  MI

  Medicare reassignment NPD
• Munson Medical Center

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1881623031
  Care Compare group NPD (past)
• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852
  Care Compare group NPD (past)
• Munson Medical Center

  • Rehabilitation Hospital Unit
  • Traverse City, MI
  • NPI 1104080621
  Care Compare group
• Munson Medical Center

  • Home Infusion Therapy Pharmacy
  • Traverse City, MI
  • NPI 1134205032
  Care Compare group
• Munson Medical Center

  • Specialty Pharmacy
  • Traverse City, MI
  • NPI 1194425447
  Care Compare group
• Munson Medical Center

  • Audiologist
  • Traverse City, MI
  • NPI 1306097167
  Care Compare group
• Munson Medical Center

  • Sleep Medicine (Internal Medicine) Physician
  • Traverse City, MI
  • NPI 1336175165
  Care Compare group
• Munson Medical Center

  • Radiation Oncology Physician
  • Traverse City, MI
  • NPI 1376097733
  Care Compare group
• Munson Medical Center

  • Social Worker
  • Traverse City, MI
  • NPI 1386672665
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kalkaska Memorial Health Center

  • Critical Access Hospital
  • Kalkaska, MI
  • NPI 1497751309

  Hospital

  Care Compare affiliation
• Munson Healthcare Otsego Memorial Hospital

  • General Acute Care Hospital
  • Gaylord, MI
  • NPI 1124028972

  Hospital

  Care Compare affiliation
• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1912996166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-7514",
            "fax_number": "231-392-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-935-7514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27483 Dequindre Rd",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Madison Heights",
            "state": "MI",
            "postal_code": "480713491",
            "country_code": "US",
            "telephone_number": "248-684-6656",
            "fax_number": "248-967-7330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 W North Down River Rd",
            "address_purpose": "LOCATION",
            "city": "Grayling",
            "state": "MI",
            "postal_code": "497382060",
            "country_code": "US",
            "telephone_number": "231-935-7514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLE",
        "first_name": "KERRY",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101012055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE NPI",
            "identifier": "1134176472",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4604280",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4578920",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN NUMBER",
            "identifier": "5821108",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkole86377@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "27483 Dequindre Rd",
            "address_2": "Suite 204",
            "city": "Madison Heights",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480713491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peter C Kohler, M.D.
• Katherine Kokowicz, LPCC
• Paul Arthur Kolak, M.A., L.P.C.
• Deborah Joubert Kolarevic, PT
• Bethany Jean Kolarik, D.C
• Marcia Lynn Kolinski, FNP-BC
• Ryan Kolle
• Kristian Michael Koller, D.O.
• Nancy Kollhoff, LPC
• Kati Lynn Komorosky

• All providers in Traverse City, MI
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.