KERRY WHITAKER (P.A.) – Physician Assistant, NPI 1164405114
Preparing for Medicare enrollment?
Use our CMS-855 prep checklist: which form applies (855I, 855O, or 855A), readiness score, NPPES field map, and Section 12 documents. Reassignment uses CMS-855I Section 4F—not the discontinued CMS-855R form.
Open Medicare 855 Prep tool →Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for KERRY WHITAKER (P.A.)
200 San Sebastian Vw
Saint Augustine, FL 320848695
Phone: (904) 209-3250
Fax: (904) 825-6875
Type: Location
20, West Kaley Street, South Orange, Orlando, Orange County, Florida, 32806, United States
ORLANDO, FL 328062931
Phone: (407) 423-2581
Fax: (407) 849-6470
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $202.
Total Amount is formed as General ($202) + Research ($0) + Ownership ($0) = $202.
Last reported payment date: 2024-10-02 • Largest payer in this snapshot: Mallinckrodt Hospital Products Inc. ($202).
Total Amount
$202
General + Research + Ownership
Payments
1
Total payment records
General Amount
$202
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Mallinckrodt Hospital Products Inc. | $202 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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 32084)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| - | FL | |
| - | FL | |
| Diagnostic Radiology, Interventional Radiology | IN | |
| - | FL | |
| - | FL |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.