Joanie Ruth Kendall, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9111596 Issued in FL

Practice address

200 E Marks St
Orlando, FL 32803-3819

Phone

(407) 284-6460

Fax

(407) 284-6461

NPI assigned

Nov 12, 2018

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

Other identifiers 1

Other names 1

• Joanie Ruth Gavin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1346718038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "407-284-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E MARKS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033819",
            "telephone_number": "407-284-6460",
            "fax_number": "407-284-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDALL",
        "first_name": "JOANIE",
        "middle_name": "RUTH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-12",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "M8468",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANIE",
            "last_name": "GAVIN",
            "middle_name": "RUTH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heidy Maritza Kempthorne
• Abigail Kempton, RBT
• Ken Drugs, Inc.
• Anne L. Kencos-Hajek, D.D.S.
• Lauren Marie Kendall Rauchfuss, M.D.
• James B Kendrick Jr.
• James Erasmus Kendrick IV, MD
• Kristen Kendrick, LMHC
• Skye Taylor Kendrick
• Jessica Kennard, D.O.

• Physician Assistant in Orlando, FL
• Providers in Orlando, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.