IndividualActive
Kerry Thek, M.D.
NPI 1457349417 · Pediatric Gastroenterology Physician · Port Orange, FL
Provider details
- NPI number
- 1457349417
- Entity type
- Individual
- Primary specialty
- Pediatric Gastroenterology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- License
- E-11212 (AR)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1690 Dunlawton Ave Ste 120
Port Orange, FL 32127-8980
Phone: (386) 677-0531
Fax: (386) 673-4658
Street-level locationGet directions
Mailing address
1690 Dunlawton Ave Ste 120
Port Orange, FL 32127-8980
Registry dates
- Enumerated
- 2005-10-12
- Last updated
- 2018-05-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.