Kristen Renee Jessee-Breeding, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110002222 Issued in VA

Practice address

16431 Wise St.
St. Paul, VA 24283-0000

Phone

(276) 762-2300

Fax

(276) 762-0612

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: kristen.breeding@vab.hcadirect.net

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.

• Western Virginia Regional Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Norton, VA
  • NPI 1386183028
  Medicare reassignment
• Russell County Medical Center Inc

  • Emergency Medicine Physician
  • Lebanon, VA
  • NPI 1801099197
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1720006000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16431 WISE STREET",
            "city": "SAINT PAUL",
            "state": "VA",
            "postal_code": "24283",
            "telephone_number": "276-762-2300",
            "fax_number": "276-762-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16431 WISE ST.",
            "city": "ST. PAUL",
            "state": "VA",
            "postal_code": "242830000",
            "telephone_number": "276-762-2300",
            "fax_number": "276-762-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSEE-BREEDING",
        "first_name": "KRISTEN",
        "middle_name": "RENEE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE TENNCARE",
            "identifier": "TN01A5",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720006000",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James A Gross, RPH
• Hamilton Pharmacy Inc
• Michael Lawrence Hamilton, PHARM. D.
• Haven LTH, LLC
• Taylor D Holliday, MD
• Andrea Johnson, PHARM.D.
• K-VA-T Food Stores Inc
• Julie Large, PHARM D
• Derek Lester McCowan
• Anthony D Meade

• Physician Assistant in St. Paul, VA
• Providers in St. Paul, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.