Individual provider Active NPI

Kendra Joelle James, NP-C, AGACNP-BC

  • Nurse Practitioner
  • Pismo Beach, CA
National Provider Identifier
1316323447
Registry record updated Jun 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95008969 Issued in CA
Practice address
2 James Way
Pismo Beach, CA 93449
Phone
(805) 295-6594
NPI assigned
Jul 30, 2015
Last updated
Jun 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95008969 CA Primary

Addresses

Primary practice location

2 James Way
Pismo Beach, CA 93449

Mailing address

2 James Way
Pismo Beach, CA 93449-4973
Phone (805) 295-6594

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherOKDO NOT HAVE AN IDENTIFICATION NUMBER YET

Other names 1

  • Mrs. Kendra Joelle Weichbrodt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180612002589 CA Practitioner - Nurse Practitioner 1658664800 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cottage Clinical Network LLCGroup PAC ID 1850712530, 57 clinicians

Practice addresses (Care Compare)

1606 E Clark Ave
Suite 2
Santa Maria, CA 93455-7507
Phone (805) 569-7351

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Coast Urgent Care Inc CurrentSince Jun 1, 2018 Accepting new patients
Cottage Clinical Network, LLC CurrentSince Mar 25, 2024 Accepting new patients
Cottage Medical Associates Past Accepting new patients

Locations

9700 El Camino Real
Ste 100
Atascadero, CA 93422
Phone (805) 461-9000

7070 Hollister Ave
Ste C23
Goleta, CA 93117

1028 N Douty St
Hanford, CA 93230
Phone (559) 530-2526

783 Quintana Rd
Ste 1
Morro Bay, CA 93442
Phone (805) 771-0108

1606 E Clark Ave
#102
Orcutt, CA 93455

2 James Way
Ste 214
Pismo Beach, CA 93449
Phone (805) 295-6594

1606 E Clark Ave
Ste 2
Santa Maria, CA 93455

1708 S Victoria Ave
Ste D
Ventura, CA 93003
Phone (805) 290-4985

Organizations & group practices 3

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 1

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": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686355200000",
    "number": "1316323447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 JAMES WAY",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934494973",
            "telephone_number": "805-295-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 JAMES WAY",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "93449",
            "telephone_number": "805-295-6594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "KENDRA",
        "middle_name": "JOELLE",
        "name_prefix": "Ms.",
        "credential": "NP-C, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2023-06-10",
        "certification_date": "2023-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95008969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DO NOT HAVE AN IDENTIFICATION NUMBER YET",
            "identifier": "NA",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDRA",
            "last_name": "WEICHBRODT",
            "middle_name": "JOELLE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pismo Beach, CA

Sources for this page

Verify at the official NPI Registry.