Individual provider Active NPI

Kendall Pfeiffer

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1487498531
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9119258 Issued in FL
Practice address
6675 Corporate Center Pkwy Ste 115
Jacksonville, FL 32216-8088
Phone
(904) 245-8910
NPI assigned
Jun 24, 2024
Last updated
Apr 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9119258 FL Primary

Addresses

Primary practice location

6675 Corporate Center Pkwy Ste 115
Jacksonville, FL 32216-8088

Mailing address

6675 Corporate Center Pkwy Ste 115
Jacksonville, FL 32216-8088
Phone (904) 245-8910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20241115000668 FL Practitioner - Physician Assistant 1658805494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Nova Southeastern College of Osteo Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone (850) 431-1155

1401 Centerville Rd
Tallahassee, FL 32308-4639

1405 Centerville Rd
Tallahassee, FL 32308-4655
Phone (850) 216-0100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9119258FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc CurrentSince Jan 1, 2025 Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince Jan 1, 2025 Accepting new patients
Tallahassee Memorial Healthcare Inc Physician Assistant Current Accepting new patients

Locations

15 Council Moore Rd
Crawfordville, FL 32327
Phone (850) 926-7105

1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360

1405 Centerville Rd
Ste 5000
Tallahassee, FL 32308
Phone (850) 877-7886

1607 Saint James Ct
Ste 1
Tallahassee, FL 32308
Phone (850) 431-7021

1609 Physicians Dr
Tallahassee, FL 32308
Phone (850) 431-4243

Interoperability endpoints

  • Direct secure messaging: kendallpfeiffer@tmhpp.allscriptsdirect.net
  • Direct secure messaging: kpfeiffer38622@tallahasseememorial.direct-ci.com

Organizations & group practices 4

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": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1487498531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6675 CORPORATE CENTER PKWY STE 115",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168088",
            "telephone_number": "904-245-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6675 CORPORATE CENTER PKWY STE 115",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168088",
            "telephone_number": "904-245-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEIFFER",
        "first_name": "KENDALL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-24",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9119258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.