Kelly Elizabeth Jernigan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

51310 Issued in CA

Practice address

145 S Fairfax Ave Ste 200&300
Los Angeles, CA 90036-2166

Phone

(929) 384-6815

Fax

(844) 440-2410

NPI assigned

Apr 3, 2013

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• KBS Medical California PC

  dba Innerwell

  • Interventional Pain Medicine Physician
  • Los Angeles, CA
  • NPI 1871475715
  NPD (past)
• Tele-Medicine Services Ny, PLLC

  • Internal Medicine Physician
  • Roseville, CA
  • NPI 1609663780
  NPD (past)

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1417290917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 S FAIRFAX AVE STE 200&300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900362166",
            "telephone_number": "929-384-6815",
            "fax_number": "844-440-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 S FAIRFAX AVE STE 200&300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900362166",
            "telephone_number": "929-384-6815",
            "fax_number": "844-440-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERNIGAN",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-03",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04024",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Lizabeth Jerez
• Dakisha Jerez
• Mia Alejandra Jerez
• Terry P Jerge, M.D.
• Cynthia Bearden Jernigan, PA-C
• Tamekia Nicole Jernigan
• Jerome E. Goldwasser, M.D.
• Jerome Tepperman Psychology Corp
• Sara M Jerome
• Elizabeth Jeronimo-Mejia

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.