KELLY L MCKERAHAN D O A PROFESSIONAL MEDICAL CORPORATION
NPI 1508110503
Clinic/Center - Primary Care in Murrieta, CA
About Kelly L Mckerahan D O A Professional Medical Corporation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY L MCKERAHAN D O A PROFESSIONAL MEDICAL CORPORATION (NPI 1508110503) is a healthcare organization registered as a primary care in Murrieta, California and active in the NPI registry since October 2012. The organization lists Kelly Lee Mckerahan, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelly L Mckerahan D O A Professional Medical Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Kelly L Mckerahan D O A Professional Medical Corporation, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kelly L Mckerahan D O A Professional Medical Corporation's NPI number?
The NPI number for Kelly L Mckerahan D O A Professional Medical Corporation is 1508110503. It was assigned to this organization in the NPPES registry on October 30, 2012.
Where is Kelly L Mckerahan D O A Professional Medical Corporation located?
Kelly L Mckerahan D O A Professional Medical Corporation is located at 25095 Jefferson Ave Ste 202, Murrieta, CA 92562. The listed phone number is (951) 696-9566.
What is Kelly L Mckerahan D O A Professional Medical Corporation's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Kelly L Mckerahan D O A Professional Medical Corporation enrolled in Medicare?
Yes. Kelly L Mckerahan D O A Professional Medical Corporation is registered in the Medicare PECOS enrollment system.
When is Kelly L Mckerahan D O A Professional Medical Corporation's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Kelly L Mckerahan D O A Professional Medical Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Kelly L Mckerahan D O A Professional Medical Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Kelly L Mckerahan D O A Professional Medical Corporation was last updated on November 13, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kelly L Mckerahan D O A Professional Medical Corporation · NPI 1508110503
Primary Care organization in Murrieta, California. Organization record, active in the CMS NPPES registry since October 30, 2012.
## Identity
- **NPI:** 1508110503 (Entity type: Organization)
- **Enumerated:** October 30, 2012
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Kelly Mckerahan, PHYSICIAN
## Practice location
- **Address:** 25095 JEFFERSON AVE STE 202, Murrieta, CA 92562-9107
- **Phone:** (951) 696-9566 · **Fax:** (951) 696-9536
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, California, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 13, 2012
- **Other identifiers:** Other GQ212A; Medicare UPIN 1508110503 (CA)
---
Source: [NPI Profile](https://npiprofile.com/npi/1508110503) · Data from the CMS NPPES public registry.