Kurt G Vernon MD PA

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

License

9501139 Issued in NC

Legal business name

KURT G VERNON MD PA

Practice address

1004 Procure Dr
Fuquay Varina, NC 27526-2620

Phone

(919) 577-0085

Fax

(919) 577-0013

NPI assigned

May 22, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Kurt Vernon, MDNPI 1871559930

Title

Medical Director

Phone

(919) 577-0085

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Kurt G Vernon MD PA

  • Gastroenterology Physician
  • Cary, NC
  • NPI 1962620997

  2860433984

  Same PAC ID

Listed as

Kurt G Vernon MD PACCN 34C0001195

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://177472a4-574c-4a73-8deb-a3663624cdb8.gastro.prod.fhir.ema-api.com/fhir/r4/

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shrija Acharya

  • Medical Physician Assistant
  • Fuquay Varina, NC
  • NPI 1013597715
  Medicare reassignment NPD
• Gabriel Ionescu, M.D.

  • Gastroenterology Physician
  • Cary, NC
  • NPI 1750315628
  Medicare reassignment NPD
• Kurt Gerard Vernon, M.D.

  • Gastroenterology Physician
  • Dunn, NC
  • NPI 1871559930
  NPD Authorized official
• Cynthia Lonigan Burkes, P.A.

  • Medical Physician Assistant
  • Coats, NC
  • NPI 1104846112
  NPD
• Ashley Marie Webb

  • Medical Physician Assistant
  • Fuquay Varina, NC
  • NPI 1194375329
  NPD
• Thomas F Dawson Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Holly Springs, NC
  • NPI 1811912884
  NPD (past)

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373328000000",
    "number": "1922444520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 PROCURE DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262620",
            "telephone_number": "919-577-0085",
            "fax_number": "919-577-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 PROCURE DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262620",
            "telephone_number": "919-577-0085",
            "fax_number": "919-577-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KURT G VERNON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-22",
        "last_updated": "2013-07-09",
        "status": "A",
        "authorized_official_last_name": "VERNON",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "919-577-0085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NC",
            "license": "9501139",
            "primary": false
        },
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "NC",
            "license": "9501139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8985016",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "85016",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "84580",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Konyn, LMFTA
• Cidney Kowalik
• Kristen L. Langworthy, DDS, PLLC
• Kroger Limited Partnership I
• Tylane Kruse
• Laboratory Corporation of America Holdings
• Alexandra Labree
• Abbey Lacastro, OTR/L
• Devin Lackey
• Savannah Summer Lagesse, LCMHCA

• Endoscopy Clinic/Center in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Endoscopy Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.