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1922177617 NPI number — JON RAYMOND KERSTETTER MD

NPI Number: 1922177617
Health Care Provider/Practitioner: JON RAYMOND KERSTETTER MD

Information about “1922177617” NPI (JON RAYMOND KERSTETTER MD) exists in 1922177617 in HTML format HTML  |  1922177617 in plain Text format TXT  |  1922177617 in PDF (Portable Document Format) PDF  |  1922177617 in an XML format XML  formats.

NPI Number : 1922177617 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1922177617",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KERSTETTER",
    "FirstName": "JON",
    "MiddleName": "RAYMOND",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2388 RUSSELL DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "IOWA CITY",
    "MailingAddressStateName": "IA",
    "MailingAddressPostalCode": "52240-9195",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "319-338-3294",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3600 30TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DES MOINES",
    "PracticeLocationAddressStateName": "IA",
    "PracticeLocationAddressPostalCode": "50310-5753",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "515-699-5800",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/07/2006",
    "LastUpdateDate": "07/09/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207P00000X",
        "TaxonomyName": "Emergency Medicine Physician",
        "LicenseNumber": "27170",
        "LicenseNumberStateCode": "IA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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