NPIMap

Individual provider Active NPI

Jennifer Anne Kang, MD

  • Obstetrics & Gynecology Physician
  • Redding, CA
National Provider Identifier
1417132572
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A125872 Issued in CA
Practice address
2216 Buenaventura Blvd
Suite B
Redding, CA 96001-3838
Phone
(530) 338-0002
Fax
(530) 643-7316
NPI assigned
Jan 8, 2008
Last updated
Sep 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X LP01012 RI
Obstetrics & Gynecology Physician 207V00000X MD2010-0229 NM
Obstetrics & Gynecology Physician 207V00000X A125872 CA Primary

Addresses

Primary practice location

2216 Buenaventura Blvd
Suite B
Redding, CA 96001-3838

Mailing address

2216 Buenaventura Blvd Ste B
Redding, CA 96001-3838
Phone (530) 338-0002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131116000025 CA Practitioner - Obstetrics/Gynecology 5092830075 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Rochester School of Medicine and Dentistry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Selah Women's Health PCGroup PAC ID 2668789207, 4 clinicians

Practice addresses (Care Compare)

2216 Buenaventura Blvd
Suite B
Redding, CA 96001-3838
Phone (530) 338-0002

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.53 of 100Reported as group
Quality
79.55
Promoting interoperability
100
Improvement activities
40
Cost
55.91

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD2010-0229NMMDObstetrics & Gynecology Physician
LP01012RIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health CurrentSince Jul 12, 2015 Accepting new patients
Dignity Health CurrentSince Jul 12, 2015 Accepting new patients
Shasta Regional Medical Center, LLC Past Accepting new patients
James D. Tate, M.D. Past Accepting new patients

Locations

2480 Sonoma St
Redding, CA 96001
Phone (530) 225-6090

310 Hartnell Ave
Ste Ac
Redding, CA 96002
Phone (530) 225-6390

Interoperability endpoints

  • Direct secure messaging: drjenneswh@selahhealth.direct.myupdox.com
  • FHIR API: https://api.platform.athenahealth.com/20136/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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 3

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": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1417132572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 BUENAVENTURA BLVD STE B",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960013838",
            "telephone_number": "530-338-0002",
            "fax_number": "530-768-1271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 BUENAVENTURA BLVD",
            "address_2": "SUITE B",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960013838",
            "telephone_number": "530-338-0002",
            "fax_number": "530-643-7316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "RI",
            "license": "LP01012",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "MD2010-0229",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A125872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.