KEVIN WERNHAM (MS) – Counselor, NPI 1104457761

KEVIN WERNHAM (MS) is a healthcare provider. based in Riverview, Florida. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MS. They hold a License No. IMH15724 (FL). The NPI Number for KEVIN WERNHAM (MS) is 1104457761

Main info

Male
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN WERNHAM (MS)
NPI
1104457761
Phone
(813) 679-0548
Address
11850 CROSS VINE DR
Enumeration Date
31 January 2020
Last Update Date
31 January 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8134034423
Graduation Year
2016 (10 years ago)
PAC ID
6305367533
Group Practice PAC ID
3577872605
Professional Enrollment ID
I20250304003858
Address ID
FL335115509BR1044XBLVD402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

3,018 MENTAL HEALTH COUNSELOR in FL

Provider Addresses for KEVIN WERNHAM (MS)

  • 11850 CROSS VINE DR

    RIVERVIEW, FL 335794300

    Phone: (813) 679-0548

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250304003858IMental Health CounselorFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33579)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3577872605View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

What is KEVIN WERNHAM (MS)'s NPI number?
KEVIN WERNHAM (MS)'s NPI is 1104457761 — the number used across U.S. healthcare to identify this provider.
Is KEVIN WERNHAM (MS) still an active registrant?
KEVIN WERNHAM (MS) carries an active NPI according to the public dataset.
What kind of doctor is KEVIN WERNHAM (MS)?
KEVIN WERNHAM (MS) is associated with Counselor in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for KEVIN WERNHAM (MS)?
Travel planning: use Riverview, Florida as the reference point for KEVIN WERNHAM (MS), then confirm.
Can I trust this NPI listing for KEVIN WERNHAM (MS)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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