Individual provider Active NPI

Jessica A Kantrales, PA

  • Physician Assistant
  • Mobile, AL
National Provider Identifier
1699296145
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
101 Memorial Hospital Dr Ste 200
Mobile, AL 36608-1787
Phone
(251) 414-5900
Fax
(251) 281-1163
NPI assigned
Jul 5, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X AL Primary

Addresses

Primary practice location

101 Memorial Hospital Dr Ste 200
Mobile, AL 36608-1787

Mailing address

101 Memorial Hospital Dr Ste 200
Mobile, AL 36608-1787
Phone (251) 414-5900

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20171109000439 AL Practitioner - Physician Assistant 8325304215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gut PCGroup PAC ID 3375589799, 53 clinicians

Practice addresses (Care Compare)

480 Honeysuckle Rd
Dothan, AL 36305-1156
Phone (334) 836-1212

Hospital & facility affiliations

  • Springhill Medical Center Hospital, Mobile, AL, CCN 010144

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Center Multi-Specialty Current Accepting new patients

Locations

101 Memorial Hospital Dr
Ste 200
Mobile, AL 36608
Phone (251) 414-3079

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": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699296145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MEMORIAL HOSPITAL DR STE 200",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081787",
            "telephone_number": "251-414-5900",
            "fax_number": "251-281-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MEMORIAL HOSPITAL DR STE 200",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081787",
            "telephone_number": "251-414-5900",
            "fax_number": "251-281-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANTRALES",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.