Active NPI
Caitlyn Jervis, PA
- Medical Physician Assistant
- Wayland, KY
National Provider Identifier
1497017669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 2643 King Kelly Coleman Hwy
Wayland, KY 41501 - Phone
- (606) 230-2255
- NPI assigned
- Jun 13, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | Primary |
Addresses
Primary practice location
2643 King Kelly Coleman Hwy
Wayland, KY 41501
Mailing address
140 Adams LN Ste 300
Pikeville, KY 41501-3088
Phone (606) 230-2255
Other practice location 1
140 Adams Ln Ste 100
Pikeville, KY 41501-3090
Phone (606) 230-2255
Other practice location 2
140 Adams Ln Ste 300
Pikeville, KY 41501-3088
Phone (606) 230-2255
Other practice location 3
1792 Alysheba Way
Lexington, KY 40509-2288
Phone (859) 335-9041
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marshall Emergency Services Associates, PLLC | Physician Assistant | Past | Accepting new patients |
| Compassion Pediatrics LLC | Medical | Past | Accepting new patients |
| Marshall West Virginia Ed Associates, LLC | Past | Accepting new patients | |
| Mesa Medical Group | Past | Accepting new patients | |
| Compassion Services | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/19494/brand/1/csg/1/fhir/r4
- caitlyn.jervis.1@19494.direct.athenahealth.com
- caitlyn.jervis.3@19494.direct.athenahealth.com
- cbrown67389@direct.kdhealth.us
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 and National Provider Directory roles.
-
- Rural Health Clinic/Center
- Pikeville, KY
- NPI 1619642972
-
- Emergency Medicine Physician
- Lexington, KY
- NPI 1891737185
Physician Assistant
-
- Emergency Medicine Physician
- Lexington, KY
- NPI 1831461755
-
- General Acute Care Hospital
- Danville, KY
- NPI 1972751469
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647216000000",
"number": "1497017669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 ADAMS LN STE 300",
"city": "PIKEVILLE",
"state": "KY",
"postal_code": "415013088",
"telephone_number": "606-230-2255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2643 KING KELLY COLEMAN HWY",
"city": "WAYLAND",
"state": "KY",
"postal_code": "41501",
"telephone_number": "606-230-2255"
}
],
"practiceLocations": [
{
"address_1": "140 Adams Ln Ste 100",
"address_purpose": "LOCATION",
"city": "Pikeville",
"state": "KY",
"postal_code": "415013090",
"country_code": "US",
"telephone_number": "606-230-2255",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "140 Adams Ln Ste 300",
"address_purpose": "LOCATION",
"city": "Pikeville",
"state": "KY",
"postal_code": "415013088",
"country_code": "US",
"telephone_number": "606-230-2255",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1792 Alysheba Way",
"address_purpose": "LOCATION",
"city": "Lexington",
"state": "KY",
"postal_code": "405092288",
"country_code": "US",
"telephone_number": "859-335-9041",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JERVIS",
"first_name": "CAITLYN",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-13",
"last_updated": "2022-03-14",
"certification_date": "2022-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayland, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.