NPIMap

Individual provider Active NPI

David Leonard Kersey, M.D.

  • Psychiatry Physician
  • Seattle, WA
National Provider Identifier
1932278348
Registry record updated Dec 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD00033040 Issued in WA
Practice address
1730 Minor Ave
Suite 1400
Seattle, WA 98101-1498
Phone
(206) 287-2601
Fax
(206) 287-2626
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD00033040 WA Primary

Addresses

Primary practice location

1730 Minor Ave
Suite 1400
Seattle, WA 98101-1498

Mailing address

1730 Minor Ave
Suite 1400
Seattle, WA 98101-1498
Phone (206) 799-3913

Other identifiers 3

IdentifierTypeStateIssuer
MD00033040OtherWAMEDICAL LICENSE NUMBER
8321937MedicaidWA
1095181MedicaidWA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00033040WAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Psychiatric Clinic Inc Past Accepting new patients
Sound PastSince Oct 20, 2019 Accepting new patients
Community Psychiatric Clinic Inc Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356912000000",
    "number": "1932278348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 MINOR AVE",
            "address_2": "SUITE 1400",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011498",
            "telephone_number": "206-799-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 MINOR AVE",
            "address_2": "SUITE 1400",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011498",
            "telephone_number": "206-287-2601",
            "fax_number": "206-287-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSEY",
        "first_name": "DAVID",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2012-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD00033040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "MD00033040",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8321937",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1095181",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; 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.