Kathleen L Spalla, PHYSICIAN ASSISTANCE

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9111078 Issued in FL

Practice address

6665 Pensacola Blvd
Pensacola, FL 32505-1705

Phone

(850) 416-2000

NPI assigned

Feb 1, 2018

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

Other identifiers 1

Other names 1

• Mrs. Kathleen Aey, Harper, Berry, Wineburner Former name

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sacred Heart Health System, IncGroup PAC ID 0244126621, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
• Gulf Breeze Hospital Hospital, Gulf Breeze, FL, CCN 100266

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathleen.spalla.1@9582.direct.athenahealth.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.

• Sacred Heart Health System, Inc.

  • Urgent Care Clinic/Center
  • Pensacola, FL
  • NPI 1770533077
  Medicare reassignment Care Compare group
• Quality Urgent Care & Wellness PL

  • Urgent Care Clinic/Center
  • Fort Walton Beach, FL
  • NPI 1861824013
  Medicare reassignment NPD
• Baptist Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Pensacola, FL
  • NPI 1558454132
  Medicare reassignment
• Tri Hospital MRI Center

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Port Huron, MI
  • NPI 1063581353
  NPD (past)

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

• Baptist Health Care, Inc.

  • General Acute Care Hospital
  • Gulf Breeze, FL
  • NPI 1972664530
  Care Compare affiliation
• Sacred Heart Health System, Inc.

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1922032424
  Care Compare affiliation

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1134628498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6665 PENSACOLA BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325051705",
            "telephone_number": "850-416-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPALLA",
        "first_name": "KATHLEEN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PHYSICIAN ASSISTANCE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-01",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134628498",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "AEY, HARPER, BERRY, WINEBURNER",
            "prefix": "MRS.",
            "credential": "PHYSICIAN ASSISTANCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peter K Soutullo, CRNA
• Luana Souza
• John C Sowers, M.D.
• Spain Wellness Center Inc
• George William Spain, D.C.
• Spanish Trail Dentistry, PA
• Spanish Trail Family Physicians, PA
• Darnita Spann, PT, DPT
• Olivia Grace Spann
• Shannon Leigh Spann, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.