NPIMap

Individual provider Active NPI

Kendra Lemery, PA-C

  • Physician Assistant
  • Spokane, WA
National Provider Identifier
1164062527
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61022876 Issued in WA
Practice address
3919 N Maple St
Spokane, WA 99205-1349
Phone
(509) 444-8200
NPI assigned
Jan 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61022876 WA Primary

Addresses

Primary practice location

3919 N Maple St
Spokane, WA 99205-1349

Mailing address

611 N Iron Bridge Way
Spokane, WA 99202-4932
Phone (509) 444-8888

Other names 1

  • Kendra Dejanovich Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200131002543 WA Practitioner - Physician Assistant 2365878873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Association of SpokaneGroup PAC ID 9638063217, 222 clinicians

Practice addresses (Care Compare)

1001 W 2ND Ave
Spokane, WA 99201-4503
Phone (509) 835-1206

3919 N Maple St
Spokane, WA 99205-1349
Phone (509) 444-8888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Association of Spokane CurrentSince Feb 18, 2020 Accepting new patients
Community Health Association of Spokane CurrentSince Feb 18, 2020 Accepting new patients
Community Health Association of Spokane Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients

Locations

1203 Idaho St
Lewiston, ID 83501
Phone (208) 848-8300

803 S Main St
Ste 120
Moscow, ID 83843
Phone (208) 848-8300

1720 2nd St
Cheney, WA 99004
Phone (207) 865-8002

5620 S Regal St
Ste 11
Spokane, WA 99223
Phone (509) 340-1590

5921 N Market St
Spokane, WA 99208
Phone (509) 487-1604

5901 N Lidgerwood St
Ste 126
Spokane, WA 99208
Phone (509) 434-1990

611 N Iron Bridge Way
Spokane, WA 99202

1001 W 2nd Ave
Spokane, WA 99201
Phone (509) 835-1205

3919 N Maple St
Spokane, WA 99205
Phone (509) 326-6900

203 N Washington St
Ste 300
Spokane, WA 99201

914 W Carlisle Ave
Spokane, WA 99205
Phone (509) 325-0393

1502 N Vercler Rd
Spokane Valley, WA 99216
Phone (509) 444-8204

15812 E Indiana Ave
Spokane Valley, WA 99216

Interoperability endpoints

  • Direct secure messaging: kendra.dejanovich.1@11411.direct.athenahealth.com

Organizations & group practices 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1164062527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N IRON BRIDGE WAY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024932",
            "telephone_number": "509-444-8888",
            "fax_number": "509-444-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 N MAPLE ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992051349",
            "telephone_number": "509-444-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMERY",
        "first_name": "KENDRA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-13",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61022876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDRA",
            "last_name": "DEJANOVICH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.