Individual provider Active NPI

Stephanie Kern, D.C

  • Chiropractor
  • Casselberry, FL
National Provider Identifier
1942625439
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 11118 Issued in FL
Practice address
853 Sr 436
Suite 1001
Casselberry, FL 32707
Phone
(386) 451-5762
Fax
(407) 960-3229
NPI assigned
Feb 20, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 11118 FL Primary

Addresses

Primary practice location

853 Sr 436
Suite 1001
Casselberry, FL 32707

Mailing address

853 Sr 436
Suite 1001
Casselberry, FL 32707
Phone (386) 451-5762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211015001087 FL Practitioner - Chiropractic 8123423555 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 11118FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Stephanie Kern Investment and Holding Company LLC Chiropractor CurrentSince Apr 1, 2023 Accepting new patients

Locations

853 State Road 436
Ste 1029
Casselberry, FL 32707
Phone (407) 960-3237

Organizations & group practices 1

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": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1942625439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 SR 436",
            "address_2": "SUITE 1001",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "32707",
            "telephone_number": "386-451-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 SR 436",
            "address_2": "SUITE 1001",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "32707",
            "telephone_number": "386-451-5762",
            "fax_number": "407-960-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERN",
        "first_name": "STEPHANIE",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-20",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 11118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casselberry, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.