Individual provider Active NPI

Jennifer Leigh Kahrl, PA-C

  • Physician Assistant
  • Hickory, NC
National Provider Identifier
1639106719
Registry record updated Sep 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-06399 Issued in NC
Practice address
1771 Tate Blvd SE Ste 204
Hickory, NC 28602-4250
Phone
(828) 322-9105
Fax
(828) 328-4999
NPI assigned
Jun 26, 2006
Last updated
Sep 25, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-06399 NC Primary
Surgical Physician Assistant 363AS0400X 0010-06399 NC

Addresses

Primary practice location

1771 Tate Blvd SE Ste 204
Hickory, NC 28602-4250

Mailing address

1771 Tate Blvd SE
Suite 204
Hickory, NC 28602-4250
Phone (828) 322-9105

Other identifiers 2

IdentifierTypeStateIssuer
P00282664OtherRAILROAD MEDICARE
001722501OtherWVBLUE CROSS BLUE SHIELD

Other names 1

  • Jennifer Leigh Davis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160705001537 NC Practitioner - Physician Assistant 1658337076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catawba Valley Medical Group IncGroup PAC ID 6305007279, 133 clinicians

Practice addresses (Care Compare)

1771 Tate Blvd SE
Suite 204
Hickory, NC 28602-4250
Phone (828) 732-5200

50 Macedonia Church Rd a
Taylorsville, NC 28681-8414
Phone (828) 732-5300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
791WVMDPsychologist
2668OHMDRegistered Dietitian
256WVMDPodiatrist
0010-06399NCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Valley Medical Group, Inc CurrentSince Jun 13, 2016 Accepting new patients
Catawba Valley Medical Group Inc CurrentSince Jun 13, 2016 Accepting new patients
Catawba Valley Medical Group Inc Past Accepting new patients
Camden Clark Memorial Hospital Corporation Past Accepting new patients

Locations

200 Rosenwald School St
Catawba, NC 28609
Phone (828) 241-2377

1771 Tate Blvd SE
Ste 204
Hickory, NC 28602
Phone (828) 322-9105

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

125 Hospital Ave NW
Ste 200C
Lenoir, NC 28645
Phone (828) 732-7500

50 Macedonia Church Rd
#A
Taylorsville, NC 28681
Phone (828) 732-5300

Interoperability endpoints

  • Direct secure messaging: jennifer.kahrl@cvmg.eclinicaldirectplus.com

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 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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506297600000",
    "number": "1639106719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771 TATE BLVD SE",
            "address_2": "SUITE 204",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286024250",
            "telephone_number": "828-322-9105",
            "fax_number": "828-328-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 TATE BLVD SE STE 204",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286024250",
            "telephone_number": "828-322-9105",
            "fax_number": "828-328-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHRL",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2017-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06399",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-06399",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00282664",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "001722501",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DAVIS",
            "middle_name": "LEIGH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.