KERA BERGERON


Address: 6025 Walnut Grove Rd Ste 207, Memphis, TN 38120-2122
Phone: 9012260200

KERA BERGERON (NPI# 1629322607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629322607
Entity Type Individual
Full Name KERA BERGERON
Credential PA-C
Practice Address 6025 Walnut Grove Rd Ste 207
Memphis
TN 38120-2122
Mailing Address 6077 Primacy Pkwy Ste 140
Memphis
TN 38119-5742
Practice Telephone 9012260200
Practice Fax Number 9012260215
Mailing Telephone 9017258347
Mailing Fax Number 9012597637
Enumeration Date 2012-10-30
Last Update Date 2019-08-27
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363AM0700X Physician Assistant
Specialization: Medical
2248 TN Physician Assistants & Advanced Practice Nursing Providers
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
2248 TN Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
TN BCBS 6186490 01
TN Q000115 05
TN MEDICARE T08648A 01

Office Location

Street Address 6025 WALNUT GROVE RD STE 207
City MEMPHIS
State TN
Zip Code 38120-2122

Providers in the same location

NPI Name Taxonomy Address Enumeration
1366485179 Jon Mark Macnaughton Orthopaedic Surgery 6025 Walnut Grove Rd Ste 207, Memphis, TN 38120-2122 2006-06-13
1528617768 Msk Group, PC Orthopaedic Surgery 6025 Walnut Grove Rd Ste 207, Memphis, TN 38120-2122 2019-09-10
1497868897 Laurence Williamson Schwartz Orthopaedic Surgery 6025 Walnut Grove Rd Ste 207, Memphis, TN 38120-2122 2006-08-17
1669490736 Jim Kyle Hudson IIi Orthopaedic Surgery 6025 Walnut Grove Rd Ste 207, Memphis, TN 38120-2122 2006-07-17

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1093285637 Cobblestone Midwifery Midwife 5617 Ashley Square South, Memphis, TN 38120 2018-11-27
1649768870 River City Neuropsychology, Pllc Psychologist 1661 International Dr., Suite 400, Memphis, TN 38120 2018-04-24
1841676152 Jody Lavaun Clements Dentist 795 Ridge Lake Blvd Ste 101, Memphis, TN 38120 2015-08-10
1578957122 Christina Lumpkin Nurse Practitioner 6305 Humphreys Blvd Ste 101, Memphis, TN 38120 2015-03-21
1316352099 Daniel Poor Emergency Medicine Baptist Memorial Hospital Memphis, 124 N. Humphrey's Blvd, Memphis, TN 38120 2014-06-21
1245643246 Kysha Saleem Nurse Practitioner 6027 Walnut Grove Rd., Suite 312, Memphis, TN 38120 2014-06-06
1376962613 John Christopher Swearingen Dentist 780 Ridge Lake Blvd Ste 101, Memphis, TN 38120 2014-04-15
1275884645 Rebecca Leigh Goedecke Nurse Practitioner 6215 Humphreys Blvd Ste 301, Memphis, TN 38120 2012-09-26
1730475179 Sarah Elizabeth Hammond Surgery Plastic Surgery Group, 80 Humphreys Blvd #100, Memphis, TN 38120 2011-06-23
1922302785 Daniel L Hester Nurse Anesthetist, Certified Registered 1755 Kirby Parkway Suite 330, Memphis, TN 38120 2011-01-07
Find all providers in zip 38120

Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1568910560 Erica Troia Comstock Physician Assistant 7193 Farnham Rd, Memphis, NY 13112-8764 2016-09-19
1578895546 Carl H. Harris Physician Assistant 6946 Finch Rd, Memphis, TN 38141-8598 2010-02-02
1831361948 F & P Certified Surgical Assistants LLC Physician Assistant 4793 Northwood Hills Cv, Memphis, TN 38128-1632 2008-03-28
1265619118 Jerry Emerson Shaw Physician Assistant 3980 New Covington Pike Ste 200, Memphis, TN 38128-2514 2008-01-23
1508974700 Mary E Bruce Physician Assistant 890 Madison Ave, Memphis, TN 38103-3409 2006-08-28
1427683796 Madison Barry Physician Assistant 877 Jefferson Ave, Memphis, TN 38103-2807 2020-03-07
1891340154 Lauren Elizabeth Whitley Physician Assistant 1325 Eastmoreland Ave Ste 365, Memphis, TN 38104-7542 2019-08-05
1518519057 Michael Trevor Houseal Physician Assistant 1325 Eastmoreland Ave Ste 365, Memphis, TN 38104-7542 2019-07-15
1427571850 Kristen Kaplon Physician Assistant 6029 Walnut Grove Rd Ste 401, Memphis, TN 38120-2112 2017-07-18
1316485667 Kathryn Lee Physician Assistant 6025 Walnut Grove Rd Ste 301, Memphis, TN 38120-2123 2017-02-07
Find all providers in MEMPHIS

Competitor

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City MEMPHIS
Zip Code 38120

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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