Jeanie Marie Kittleson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA833 Issued in NV

Practice address

St Rose Dominican de Lima
102 E Lake Mead Pkwy
Henderson, NV 89015

Phone

(702) 616-4600

Fax

(702) 616-4311

NPI assigned

Feb 27, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, FL, GA, IA, WI5 enrollments

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 5

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercyone North Iowa Medical Center Hospital, Mason City, IA, CCN 160064

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Florida Hospital Medical Group Inc

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234

  Physician Assistant

  Medicare reassignment NPD
• North Iowa Mercy Clinics

  • Anesthesiology Physician
  • Mason City, IA
  • NPI 1780278242
  Medicare reassignment NPD
• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Multi-Specialty Clinic/Center
  • Neenah, WI
  • NPI 1730126392
  Medicare reassignment
• Columbia St. Mary'S Hospital Milwaukee, Inc

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1023064482
  Medicare reassignment
• Florida Hospital Healthcare Partners, Inc

  • Internal Medicine Physician
  • Daytona Beach, FL
  • NPI 1780100529
  Medicare reassignment
• Piedmont Cardiology of Atlanta, LLC

  • Cardiovascular Disease Physician
  • Atlanta, GA
  • NPI 1275729691
  Medicare reassignment
• Southeastern Regional Medical Center

  • Clinic/Center
  • Lumberton, NC
  • NPI 1154399699
  Medicare reassignment
• Saint Mary'S Medical Group Inc

  • Community/Retail Pharmacy
  • Reno, NV
  • NPI 1447635578
  NPD
• Saint Marys Urgent Care LLC

  • Multi-Specialty Clinic/Center
  • Reno, NV
  • NPI 1275898975
  NPD
• Florida Hospital Medical Group Inc

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD
• North Iowa Mercy Clinics

  • Family Medicine Physician
  • Sheffield, IA
  • NPI 1972513026
  NPD
• North Iowa Mercy Clinics

  • Sports Medicine (Family Medicine) Physician
  • Mason City, IA
  • NPI 1982300349
  NPD

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

• Mercy Health Services-Iowa Corp

  • Rural Acute Care Hospital
  • Mason City, IA
  • NPI 1467537886
  Care Compare affiliation

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1164559415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 HANLEY WAY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890745387",
            "telephone_number": "252-258-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST ROSE DOMINICAN DE LIMA",
            "address_2": "102 E LAKE MEAD PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89015",
            "telephone_number": "702-616-4600",
            "fax_number": "702-616-4311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 W Horizon Ridge Pkwy Ste 241",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890525013",
            "country_code": "US",
            "telephone_number": "702-233-9222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3001 Saint Rose Pkwy",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890523839",
            "country_code": "US",
            "telephone_number": "702-616-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8280 W Warm Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891133612",
            "country_code": "US",
            "telephone_number": "702-492-8632",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2250 E Flamingo Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891195170",
            "country_code": "US",
            "telephone_number": "702-784-4300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Kindred Hospital de Lima",
            "address_2": "102 E. Lake Mead Parkway",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "89015",
            "country_code": "US",
            "telephone_number": "702-856-0633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8550 S Eastern Ave",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891232835",
            "country_code": "US",
            "telephone_number": "702-382-3155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 E Rollins St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328031248",
            "country_code": "US",
            "telephone_number": "407-303-7283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KITTLESON",
        "first_name": "JEANIE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA833",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9114559",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": "PA833",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100503035",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marveletta Kirk
• Tim M Kirkpatrick
• Myesha Kirmen
• Joanna Kisielewski
• Allahna Kitchen
• Joseph Klarberg
• Joseph P Klein, MD
• Madeline Klein
• Messina Dawn Klein, LPTA
• Laurel A Kleinman, APN

• Physician Assistant in Henderson, NV
• Providers in Henderson, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.