Jermahl David McKissick, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1091561 Issued in NE

Practice address

10651 E St
Naval Health Clinic Corpus Christi TX
Corpus Christi, TX 78419-5130

Phone

(559) 513-1586

NPI assigned

Jun 2, 2010

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275436800000",
    "number": "1194045187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10651 E ST",
            "address_2": "NAVAL HEALTH CLINIC CORPUS CHRISTI TX",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784195130",
            "telephone_number": "559-513-1586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10651 E ST",
            "address_2": "NAVAL HEALTH CLINIC CORPUS CHRISTI TX",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784195130",
            "telephone_number": "559-513-1586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKISSICK",
        "first_name": "JERMAHL",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-02",
        "last_updated": "2010-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1091561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann McKenna, LCSW
• McKenzie Orthodontics
• Lisa Lauren McKinstry, FNP
• Scott William McKinstry, M.D.
• Kallieste McKinzey, STUDENT
• Nicholas McLain, M.D.
• William Bell McLaird, DDS
• Lauren Guerra McLaughlin, SLP-CF
• Nikole M McLean, DNP, FNP-BC, AFN-C
• Claude A McLelland, MD

• Medical Physician Assistant in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; 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.