NPIMap

Individual provider Active NPI

Kaola Japria Bovell, CRNP

  • Family Nurse Practitioner
  • Fredericksburg, PA
National Provider Identifier
1265056204
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP022103 Issued in PA
Practice address
120 S Tan Aly Ste 1
Fredericksburg, PA 17026-9349
Phone
(717) 865-6644
Fax
(717) 865-5666
NPI assigned
Jun 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN567859 PA
Family Nurse Practitioner 363LF0000X SP022103 PA Primary

Addresses

Primary practice location

120 S Tan Aly Ste 1
Fredericksburg, PA 17026-9349

Mailing address

120 S Tan Aly Ste 1
Fredericksburg, PA 17026-9349
Phone (717) 865-6644

Other practice location 1

100 E Queen St
Jonestown, PA 17038-9774
Phone (717) 865-2162

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kbovell176341@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200727001406 PA Practitioner - Nurse Practitioner 2668896424 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

120 S Tan Aly
Suite 1
Fredericksburg, PA 17026-9349
Phone (717) 865-6644

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.61 of 100Reported as group
Quality
83.98
Promoting interoperability
100
Improvement activities
40
Cost
78.06

Merit-based Incentive Payment System (MIPS)

Final score
86.08 of 100Reported as group
Quality
76.48
Promoting interoperability
100
Improvement activities
40
Cost
77.12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN567859PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Regional Physicians CurrentSince Mar 1, 2023 Accepting new patients
Pinnacle Health Medical Services CurrentSince Jul 21, 2020 Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients
Pinnacle Health Medical Services CurrentSince Jul 21, 2020 Accepting new patients
Pinnacle Health Regional Physicians CurrentSince Mar 1, 2023 Accepting new patients
Pinnacle Health Medical Services Past Accepting new patients

Locations

210 Forge Rd
Boiling Springs, PA 17007
Phone (717) 249-8300

120 S Tan Aly
Ste 1
Fredericksburg, PA 17026

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

100 E Queen St
Jonestown, PA 17038
Phone (717) 865-0739

1871 Santa Barbara Dr
Ste 1
Lancaster, PA 17601
Phone (717) 560-1970

Interoperability endpoints

  • Direct secure messaging: kbovell282266@upmc.direct-ci.com

Organizations & group practices 6

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 12

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": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1265056204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S TAN ALY STE 1",
            "city": "FREDERICKSBURG",
            "state": "PA",
            "postal_code": "170269349",
            "telephone_number": "717-865-6644",
            "fax_number": "717-865-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S TAN ALY STE 1",
            "city": "FREDERICKSBURG",
            "state": "PA",
            "postal_code": "170269349",
            "telephone_number": "717-865-6644",
            "fax_number": "717-865-5666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Queen St",
            "address_purpose": "LOCATION",
            "city": "Jonestown",
            "state": "PA",
            "postal_code": "170389774",
            "country_code": "US",
            "telephone_number": "717-865-2162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOVELL",
        "first_name": "KAOLA",
        "middle_name": "JAPRIA",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN567859",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP022103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbovell176341@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "100 E Queen St",
            "city": "Jonestown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170389774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fredericksburg, PA

Sources for this page

Verify at the official NPI Registry.