Jason Aaron Canterberry, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9107697 Issued in FL

Practice address

510 Ruby Dr
Madisonville, KY 42431-2168

Phone

(270) 399-7900

Fax

(270) 399-7910

NPI assigned

Jan 13, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/critten-2b2d21fb

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.

• Crittenden Community Hospital LLC

  • Emergency Medicine Physician
  • Marion, KY
  • NPI 1275097339

  Physician Assistant

  Medicare reassignment NPD (past)
• Owensboro Health Medical Group Inc

  • Surgery Physician
  • Greenville, KY
  • NPI 1235518242
  Medicare reassignment
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382
  Medicare reassignment
• Crittenden Community Hospital LLC

  • Clinic/Center
  • Sturgis, KY
  • NPI 1013727882
  NPD
• Crittenden Community Hospital LLC

  • Rural Health Clinic/Center
  • Fredonia, KY
  • NPI 1841933496
  NPD
• Family Practice Clinic PSC

  • Family Medicine Physician
  • Marion, KY
  • NPI 1467454041
  NPD
• Owensboro Health Medical Group Inc

  • Internal Medicine Physician
  • Owensboro, KY
  • NPI 1306700711
  NPD
• Owensboro Health Medical Group, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Leitchfield, KY
  • NPI 1689367831
  NPD

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

{
    "created_epoch": "1389571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1588086433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 RUBY DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424312168",
            "telephone_number": "270-399-7900",
            "fax_number": "270-399-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTERBERRY",
        "first_name": "JASON",
        "middle_name": "AARON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-13",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9107697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcanterberry116101@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "510 Ruby Dr",
            "city": "Madisonville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "424312168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicholas Tate Burris
• Kara Burrow, COTA/L
• Misty Burton, OTR/L
• Jamie Lynn Byars, PHARMD
• Corina Byford, PHARMD
• Kelly Frances Canterberry, NP-C
• Brianna Shaunte Capel, RN, CEBP, MAED.
• Cardiology Consultants, PSC
• Caris Counseling & Behavioral Health Group
• Jason Matthew Carl, MA, ATC, CSCS

• Physician Assistant in Madisonville, KY
• Providers in Madisonville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.