Individual provider Active NPI

Katie Joffe, PA-C

  • Physician Assistant
  • Bay Minette, AL
National Provider Identifier
1285996678
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.1063 Issued in AL
Practice address
1815 Hand Ave
Bay Minette, AL 36507-4110
Phone
(251) 937-5521
NPI assigned
Jun 12, 2012
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 PA.1063 AL Primary
Medical Physician Assistant 363AM0700X 006470 GA

Addresses

Primary practice location

1815 Hand Ave
Bay Minette, AL 36507-4110

Mailing address

912 Van Ave Apt 626
Daphne, AL 36526-8615

Other practice location 1

204 Professional Ct SE
Calhoun, GA 30701-7020
Phone (706) 625-5900

Other identifiers 1

IdentifierTypeStateIssuer
PA.1063OtherALPA LICENSE ALABAMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20160208000400 AL Practitioner - Physician Assistant 7214231521 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006470GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Agc Pediatrics, LLC PastSince Sep 23, 2019 Accepting new patients
Agc Pediatrics, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEJAAA

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1285996678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 VAN AVE APT 626",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365268615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 HAND AVE",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365074110",
            "telephone_number": "251-937-5521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 Professional Ct SE",
            "address_purpose": "LOCATION",
            "city": "Calhoun",
            "state": "GA",
            "postal_code": "307017020",
            "country_code": "US",
            "telephone_number": "706-625-5900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOFFE",
        "first_name": "KATIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.1063",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "006470",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE ALABAMA",
            "identifier": "PA.1063",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Minette, AL

Sources for this page

Verify at the official NPI Registry.