Kimberly Anne Channels, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 3270 Issued in FL

Practice address

15320 Amberly Dr
Suite, a
Tampa, FL 33647-1647

Phone

(813) 977-0733

Fax

(813) 971-2230

NPI assigned

Mar 9, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellmed Medical Management of Florida IncGroup PAC ID 3971678558, 158 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Tampa Hospital, Tampa, FL, CCN 100173
• St Josephs Hospital Hospital, Tampa, FL, CCN 100075
• Adventhealth Wesley Chapel Hospital, Wesley Chapel, FL, CCN 100319

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: kimberly.channels@wellmed.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wellmed Medical Management of Florida Inc

  • Family Medicine Physician
  • Port St Lucie, FL
  • NPI 1033395397
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pasco-Pinellas Hillsborough Community Health System Inc

  • General Acute Care Hospital
  • Wesley Chapel, FL
  • NPI 1073893020
  Care Compare affiliation
• St. Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1346519816
  Care Compare affiliation
• St. Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1881632818
  Care Compare affiliation
• University Community Hospital, Inc

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1053321919
  Care Compare affiliation
• University Community Hospital, Inc

  • Clinical Medical Laboratory
  • Tampa, FL
  • NPI 1134766694

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1053443796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15320 AMBERLY DR",
            "address_2": "STE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336471647",
            "telephone_number": "813-977-2090",
            "fax_number": "813-977-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15320 AMBERLY DR",
            "address_2": "SUITE, A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336471647",
            "telephone_number": "813-977-0733",
            "fax_number": "813-971-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANNELS",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 3270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT ID",
            "identifier": "PA LICENSE PA 3270",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter Travis Riad Chang, M.D.
• Simone M Chang, MD
• Young Doo Chang, M.D.
• Change the Narrative Counseling LLC
• Varun Channagiri, M.D.
• Channelside Optical LLC
• Arthur Channer, PSY.D., BCBA-D
• Aimon Amy Chantara, PHARMD
• Cattaleeya Chantaros, APRN
• Charmelene Chanthabouasith

• Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.