Jenisa K Ryals, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 166 Issued in AL

Practice address

1108 Ross Clark Cir
Dothan, AL 36301-3022

Phone

(334) 255-7747

Fax

(877) 374-1670

NPI assigned

Oct 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Jenisa R Quinley Former name

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Keystone Medical Services of Alabama, Inc.Group PAC ID 7719365352, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Keystone Medical Services of Alabama, Inc.

  • Emergency Medicine Physician
  • Troy, AL
  • NPI 1790432243
  Medicare reassignment Care Compare group NPD
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349

  Physician Assistant

  NPD
• Pensacola Nephrology, PA

  • Nephrology Physician
  • Pensacola, FL
  • NPI 1700829728
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Houston County Healthcare Authority

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1164403861
  Care Compare affiliation

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1669568267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 311311",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363311311",
            "telephone_number": "334-255-7747",
            "fax_number": "877-374-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013022",
            "telephone_number": "334-255-7747",
            "fax_number": "877-374-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYALS",
        "first_name": "JENISA",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101955",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA 166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891003240",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291215500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "059054065",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENISA",
            "last_name": "QUINLEY",
            "middle_name": "R",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tommy Ray Rushing
• Robert Cody Russell
• Ruthanne Wilkes, LLC
• Travis J Rutland, MD
• RX Pro of Alabama LLC
• Morgan Ryals, NP
• Saylor Ryals, CRNP
• Carmen Ryan, CRNA
• Emily Carol Ryan
• S E Intervention Group, Inc

• Physician Assistant in Dothan, AL
• Providers in Dothan, AL by specialty
• Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.