Jessica Myendu Kabala

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

31936 Issued in TN

Practice address

1100 9TH Ave
Seattle, WA 98101-2756

Phone

(206) 223-2319

Fax

(206) 341-1405

NPI assigned

Feb 21, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, TN2 enrollments

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 2

Specialty

Nurse Practitioner

Education

University of Washington School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Saint Thomas Medical PartnersGroup PAC ID 1557269354, 588 clinicians

Washington Gastroenterology PLLCGroup PAC ID 6204194848, 142 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Thomas Rutherford Hospital Hospital, Murfreesboro, TN, CCN 440053
• St Michael Medical Center Hospital, Silverdale, WA, CCN 500039

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkabala60699@skagit.direct-ci.com

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.

• Washington Gastroenterology PLLC

  • Gastroenterology Physician
  • Tacoma, WA
  • NPI 1306364401
  Medicare reassignment Care Compare group NPD
• Saint Thomas Medical Partners

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1437194669
  Medicare reassignment Care Compare group NPD
• Public Hospital Dist No 1 Skagit

  • General Practice Physician
  • Mount Vernon, WA
  • NPI 1023332749
  Medicare reassignment NPD
• Public Hospital Dist No 1 Skagit

  • Rural Health Clinic/Center
  • Darrington, WA
  • NPI 1013064575
  NPD
• Public Hospital Dist No 1 Skagit

  • Physical Therapist
  • Mount Vernon, WA
  • NPI 1811460652
  NPD
• Washington Gastroenterology PLLC

  • Clinical Medical Laboratory
  • Federal Way, WA
  • NPI 1245265826
  NPD
• Washington Gastroenterology PLLC

  • Clinical Medical Laboratory
  • Federal Way, WA
  • NPI 1467011122
  NPD
• Public Hospital Dist No 1 Skagit

  • Specialist
  • Mount Vernon, WA
  • NPI 1629012463
  NPD (past)

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

• Commonspirit Washington Community Care

  • General Acute Care Hospital
  • Silverdale, WA
  • NPI 1518912609
  Care Compare affiliation
• Saint Thomas Rutherford Hospital

  • General Acute Care Hospital
  • Murfreesboro, TN
  • NPI 1164590386
  Care Compare affiliation

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1699308239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-223-2319",
            "fax_number": "206-341-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-223-2319",
            "fax_number": "206-341-1405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Medical Center Pkwy",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371292245",
            "country_code": "US",
            "telephone_number": "615-396-4694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KABALA",
        "first_name": "JESSICA",
        "middle_name": "MYENDU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-21",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "WA",
            "license": "60696072",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61084558",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "31936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Jyringi, DC
• K Aylen DDS PLLC
• K&Y Ro LLC
• Petronella Johanna Kaandorp
• Christina Kaba, MD
• Michael Augustin Kabalin, PHARM.D.
• Araba Kabaro
• Megan Kabat, RN
• Rachel Kabodian, LMP
• Apollo Kanyonyi Kabukuru, MD

• Nurse Practitioner in Seattle, WA
• Providers in Seattle, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.