Individual provider Active NPI

Kerri E Ward, D.C.

  • Chiropractor
  • Port St Lucie, FL
National Provider Identifier
1952472136
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8374 Issued in FL
Practice address
304 NW Bethany Dr.
Port St Lucie, FL 34986-3578
Phone
(772) 344-1431
Fax
(772) 344-1435
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH8374 FL Primary

Addresses

Primary practice location

304 NW Bethany Dr.
Port St Lucie, FL 34986-3578

Mailing address

304 NW Bethany Dr.
Port St Lucie, FL 34986-3578
Phone (772) 344-1431

Other identifiers 4

IdentifierTypeStateIssuer
K7838OtherFLMEDICARE GROUP
381511100MedicaidFL
202306175OtherFLTAX ID
1992993471OtherFLMEDICARE GROUP NPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050726000245 FL Practitioner - Chiropractic 3476580291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

304 NW Bethany Dr
Port Saint Lucie, FL 34986-3578
Phone (772) 344-1431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Achieving Wellness Chiropractic Center, LLC Chiropractor CurrentSince Feb 25, 2005 Accepting new patients
Sykes Chiropractic Life Center Chiropractor Past Accepting new patients

Locations

304 NW Bethany Dr
Port St Lucie, FL 34986
Phone (772) 344-1431

Organizations & group practices 2

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1952472136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 NW BETHANY DR.",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863578",
            "telephone_number": "772-344-1431",
            "fax_number": "772-344-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 NW BETHANY DR.",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863578",
            "telephone_number": "772-344-1431",
            "fax_number": "772-344-1435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "KERRI",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "K7838",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381511100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "202306175",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NPI",
            "identifier": "1992993471",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; 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.