Individual provider Active NPI

Jakob Kinsey, PA

  • Physician Assistant
  • Fishersville, VA
National Provider Identifier
1184299000
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110008373 Issued in VA
Practice address
70 Medical Center Cir Ste 213
Fishersville, VA 22939-2273
Phone
(540) 245-7705
Fax
(540) 245-7710
NPI assigned
May 24, 2021
Last updated
Jun 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110008373 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

70 Medical Center Cir Ste 213
Fishersville, VA 22939-2273

Mailing address

PO Box 388
Fishersville, VA 22939-0388
Phone (540) 245-7705

Other practice location 1

2809 N Morgan Valley Dr
Morgan, UT 84050-9642
Phone (801) 829-8841

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jake.kinsey.1@14718.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20220321000359 VA Practitioner - Physician Assistant 7012302516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Augusta Medical GroupGroup PAC ID 3678632544, 409 clinicians

Practice addresses (Care Compare)

53 S Medical Park Dr
Fishersville, VA 22939-2333
Phone (540) 332-5687

78 Medical Ctr Dr
Fishersville, VA 22939-2332
Phone (540) 332-5595

9 S Medical Park Dr
Fishersville, VA 22939-2333
Phone (540) 245-7350

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Augusta Medical Group Multi-Specialty CurrentSince Mar 14, 2022 Accepting new patients

Locations

540 Radford Ln
Ste 250
Charlottesville, VA 22903
Phone (434) 823-7596

53 S Medical Park Dr
Fishersville, VA 22939
Phone (540) 332-5687

70 Medical Center Cir
Ste 213
Fishersville, VA 22939
Phone (540) 245-7705

644 University Blvd
Harrisonburg, VA 22801
Phone (540) 564-5100

30 Greenhouse Rd
Lexington, VA 24450
Phone (540) 464-3465

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14718/brand/4/csg/1/fhir/r4

Organizations & group practices 1

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1184299000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229390388",
            "telephone_number": "540-245-7705",
            "fax_number": "540-245-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MEDICAL CENTER CIR STE 213",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392273",
            "telephone_number": "540-245-7705",
            "fax_number": "540-245-7710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2809 N Morgan Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Morgan",
            "state": "UT",
            "postal_code": "840509642",
            "country_code": "US",
            "telephone_number": "801-829-8841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINSEY",
        "first_name": "JAKOB",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-24",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008373",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jake.kinsey.1@14718.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "address_1": "70 Medical Center Cir Ste 213",
            "city": "Fishersville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229392273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

Verify at the official NPI Registry.