Kanani Wasilk-Kindred, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

237594 Issued in AZ

Practice address

875 W Pecos Rd Apt 2113
Chandler, AZ 85225-7613

Phone

(503) 545-7917

NPI assigned

Nov 10, 2023

Last updated

Nov 10, 2023By the provider in NPPES

Sex

Female

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

Enrolled in AZ, OR2 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 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jacobs Mental Health ServicesGroup PAC ID 0749721702, 6 clinicians

JJM MedicalGroup PAC ID 8921419151, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• JJM Medical

  • Psychiatric/Mental Health Nurse Practitioner
  • Scottsdale, AZ
  • NPI 1033711312
  Medicare reassignment Care Compare group NPD
• Jacobs Mental Health Services

  dba Skycloud Mental Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Clackamas, OR
  • NPI 1407573850
  Medicare reassignment Care Compare group NPD
• Jacobs MH of Washington

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Issaquah, WA
  • NPI 1033910450

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1699574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1255105193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 W PECOS RD APT 2113",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852257613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 W PECOS RD APT 2113",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852257613",
            "telephone_number": "503-545-7917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASILK-KINDRED",
        "first_name": "KANANI",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-10",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "237594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Waselkow Jr.
• Nikki Waseta
• Nada Fathi Washington, PA-C
• Stephanie Danyel Washingtoncook
• Annie McKee Washio, ND
• Laura Wasley
• Joseph Francis Villanueva Wasneski, NMD
• Megan Wasser
• Allison Diane Wasz
• Watel Solutions Corp

• Psychiatric/Mental Health Nurse Practitioner in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; 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.