Individual provider Active NPI

Bryanna Elizabeth Kinna, PA-C

  • Physician Assistant
  • Lewisburg, PA
National Provider Identifier
1649632274
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA058232 Issued in PA
Practice address
131 JPM Rd Ste a
Lewisburg, PA 17837-9309
Phone
(570) 523-6115
Fax
(570) 523-6178
NPI assigned
Mar 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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 OA003810 PA
Physician Assistant 363A00000X MA058232 PA Primary

Addresses

Primary practice location

131 JPM Rd Ste a
Lewisburg, PA 17837-9309

Mailing address

7 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-2123

Other identifiers 1

IdentifierTypeStateIssuer
1031819960001MedicaidPA

Other names 1

  • Bryanna Elizabeth Evens Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bryannakinna@fpc.medentdirect.com Health Information Exchange (HIE) FAMILY PRACTICE CENTER, PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20160829001207 PA Practitioner - Physician Assistant 0143515205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Practice Center PCGroup PAC ID 0244124212, 351 clinicians

Practice addresses (Care Compare)

1 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-5889

131 JPM Rd
Lewisburg, PA 17837-9309
Phone (570) 523-6115

Hospital & facility affiliations

  • Wellspan Evangelical Community Hospital Hospital, Lewisburg, PA, CCN 390013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OA003810PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Center, PC Physician Assistant CurrentSince Aug 1, 2016 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

131 Jpm Rd
Ste A
Lewisburg, PA 17837
Phone (570) 523-6115

7 Dock Hill Rd
Middleburg, PA 17842
Phone (570) 837-2123

137 Forest Hill Rd
Mifflinburg, PA 17844
Phone (570) 966-1004

270 Susquehanna Valley Mall Dr
Ste 100
Selinsgrove, PA 17870
Phone (570) 743-1703

Interoperability endpoints

  • Direct secure messaging: bryannakinna@fpc.medentdirect.com

Organizations & group practices 2

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.

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": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1649632274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DOCK HILL RD",
            "city": "MIDDLEBURG",
            "state": "PA",
            "postal_code": "178428910",
            "telephone_number": "570-837-2123",
            "fax_number": "570-837-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 JPM RD STE A",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379309",
            "telephone_number": "570-523-6115",
            "fax_number": "570-523-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNA",
        "first_name": "BRYANNA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-23",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA003810",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031819960001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bryannakinna@fpc.medentdirect.com",
            "affiliation": "Y",
            "affiliationName": "FAMILY PRACTICE CENTER, PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "131 Jpm Rd Ste A",
            "city": "Lewisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178379309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRYANNA",
            "last_name": "EVENS",
            "middle_name": "ELIZABETH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lewisburg, PA

Sources for this page

Verify at the official NPI Registry.