Jessica Sara Kallish

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT017330 Issued in GA

Practice address

9390 The Landing Dr # 201
Douglasville, GA 30135-7180

Phone

(770) 852-1692

NPI assigned

Sep 16, 2024

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

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment Care Compare group NPD
• Multicare Health System

  • Clinical Medical Laboratory
  • Tacoma, WA
  • NPI 1154818326
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  • Family Medicine Physician
  • Auburn, WA
  • NPI 1013969195

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1750118519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 SAINT DEVON XING",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300978067",
            "telephone_number": "770-286-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9390 THE LANDING DR # 201",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301357180",
            "telephone_number": "770-852-1692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLISH",
        "first_name": "JESSICA",
        "middle_name": "SARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Paul Justice, CCC-A
• K&W Care Homes
• Soccoh A Kabia, M.D.
• Kaiser Foundation Health Plan of Georgia, Inc.
• Kaiser Permanente
• Kamlesh D. Nayak, MD, PC
• Justine Misenga Kandolo, M.D.
• Ji Hoon Kang
• Diane L Kaplan, AU.D.
• Baraka Karanja

• Physical Therapist in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.