Kenneth Gerdes , LLC
NPI 1679514095ActiveOrganization· Specialist· Saint Louis, MO
Specialist in Saint Louis, Missouri, registered in NPPES in June 2006. The authorized official on file is Jacki Jordan, Billing Manager. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1679514095 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 9, 2006 |
| Last updated in NPPES | Dec 10, 2024 |
| Certified by provider | Dec 10, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | 117124 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IL); Part B Supplier - Clinic/Group Practice (MO) |
|---|
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