Casey Nicole Gernon, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA20023 Issued in CA

Practice address

14011 Park Ave
Dept. of Family Medicine
Victorville, CA 92392

Phone

(760) 843-2423

NPI assigned

Sep 23, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Mrs. Casey Nicole Hewitt Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1972753374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14011 PARK AVE",
            "address_2": "DEPT. OF FAMILY MEDICINE",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92392",
            "telephone_number": "760-843-2423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14011 PARK AVE",
            "address_2": "DEPT. OF FAMILY MEDICINE",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92392",
            "telephone_number": "760-843-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERNON",
        "first_name": "CASEY",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20023",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "1085196",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASEY",
            "last_name": "HEWITT",
            "middle_name": "NICOLE",
            "prefix": "MRS.",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physician Assistant in Victorville, CA
• Providers in Victorville, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.