Jennifer Renee Kolle, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6955 Issued in AZ

Practice address

890 W Elliot Rd
Gilbert, AZ 85233-5102

Phone

(602) 510-3939

NPI assigned

Oct 23, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations (25 of 28)

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FFDEBA/Endpoint/FFDEBA

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.

• Honorhealth-Fastmed Ambulatory Holdings LLC

  • Urgent Care Clinic/Center
  • Surprise, AZ
  • NPI 1467069047
  Medicare reassignment
• Honorhealth-Fastmed Ambulatory Holdings LLC

  • Urgent Care Clinic/Center
  • Glendale, AZ
  • NPI 1144837766
  NPD
• Honorhealth-Fastmed Ambulatory Holdings LLC

  • Urgent Care Clinic/Center
  • Tucson, AZ
  • NPI 1801403480
  NPD
• Tri-City Express Care, PLLC

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1649554940
  NPD
• Honorhealth Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1740273614
  NPD (past)
• Tri-City Express Care, PLLC

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1376981092
  NPD (past)
• Tri-City Express Care, PLLC

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1477818730
  NPD (past)
• Tri-City Express Care, PLLC

  • Urgent Care Clinic/Center
  • Tolleson, AZ
  • NPI 1750728523
  NPD (past)
• Tri-City Express Care, PLLC

  • Family Medicine Physician
  • Gilbert, AZ
  • NPI 1962580118
  NPD (past)
• Tri-City Express Care, PLLC

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1972929081
  NPD (past)
• Whispering Palms Medical Inc

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1821314998
  NPD (past)

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508716800000",
    "number": "1073024675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "694 W BARTLETT WAY",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852485088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 W ELLIOT RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852335102",
            "telephone_number": "602-510-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLE",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-23",
        "last_updated": "2017-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Mawunyo Koffie, MD
• Tyler James Kolb
• Agnes Koldenhoven, RDN
• Diamond W Koleah
• Samantha T. Kolinski, D.D.S.
• Joseph Paul Kolter Jr., M.D.
• Tatum Thomas Komenda, PA-C
• Kona Counseling PC
• Sydney Lynn Konatske, MS, CF-SLP
• Lara Konenko, PSYD

• Physician Assistant in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.