Jason Lee Kissick

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11007202 Issued in FL

Practice address

3301 W Gandy Blvd
Tampa, FL 33611-2931

Phone

(813) 925-1903

NPI assigned

May 14, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jason.kissick.1@13869.direct.athenahealth.com

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

• Dispatchhealth-Florida Inc.

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1407472723

  Single Specialty

  NPD
• Dispatchhealth-Florida Inc.

  • Emergency Medicine Physician
  • Doral, FL
  • NPI 1154097491

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1295357051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N 12TH ST UNIT 202",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024205",
            "telephone_number": "813-363-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 W GANDY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336112931",
            "telephone_number": "813-925-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSICK",
        "first_name": "JASON",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-14",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "FL",
            "license": "9350626",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11007202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bela Kis, M.D., PH.D.
• Megan M Kise, PA-C
• Elizabeth A Kisenishsky, APRN
• Julie A. Kish, M. D., FACP
• Kismet Kare
• Carrington Taylor Kissner
• Dawn Marie Kita
• Samara Kitchen
• Ashley Simone Kitchens
• Kennedy Anne Kitchens

• Family Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; 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.