Jessica Kimball

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

339785 Issued in NY

Practice address

61 Delano St
Pulaski, NY 13142-1400

Phone

(315) 298-6569

NPI assigned

Jul 7, 2015

Sex

Female

Sole proprietor

No

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 TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jessica.kimball@nochsi.directbygreenway.com
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  TN

  Medicare reassignment NPD
• Lake Ontario Prompt Medical Care, PLLC

  • Rural Health Clinic/Center
  • Oswego, NY
  • NPI 1144918566
  NPD

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1326421504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 DELANO ST",
            "city": "PULASKI",
            "state": "NY",
            "postal_code": "131421400",
            "telephone_number": "315-298-6569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 DELANO ST",
            "city": "PULASKI",
            "state": "NY",
            "postal_code": "131421400",
            "telephone_number": "315-298-6569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Hollis, RN
• Jay F Sullivan MD PC
• Robert Kang, DDS
• Sally Katharine Kelleher, MSED
• Charles C Kim, MD
• Miranda King, NP
• Kathleen M Kinney, LPN
• KPH Healthcare Services, Inc.
• Missy A Kruszelnicki, PTA
• Kwi Lee, DDS

• Family Nurse Practitioner in Pulaski, NY
• Providers in Pulaski, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; 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.