Active NPI
Jayanthi Kini, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Springfield, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- MD152979
- Practice address
- 123 International Way
Springfield, OR 97477-1047 - Phone
- (541) 341-8063
- Fax
- (541) 341-8099
- NPI assigned
- Nov 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | MD00038975 | WA | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | MD152979 | OR | Primary |
Addresses
Primary practice location
123 International Way
Springfield, OR 97477-1047
Mailing address
123 International Way
Springfield, OR 97477-1047
Phone (541) 341-8063
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pathology
- Education
- Other, 1973
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1430 W 'C' St
Russellville, AR 72801-2805
1430 W C St
Russellville, AR 72811-0925
Phone (479) 968-6781
PO Box
Suite 925
Russellville, AR 72811-0925
Hospital & facility affiliations
- National Park Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD152979 | OR | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathology Services Laboratory PA | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
| Pathology Services Laboratory PA | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
Locations
1430 W C St
Russellville, AR 72801
Phone (479) 968-6781
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.
-
- Anatomic Pathology & Clinical Pathology Physician
- Russellville, AR
- NPI 1831158369
-
- Clinical Medical Laboratory
- Russellville, AR
- NPI 1093889347
Anatomic Pathology & Clinical Pathology
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hot Springs, AR
- NPI 1841241833
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298937600000",
"number": "1801975925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 INTERNATIONAL WAY",
"city": "SPRINGFIELD",
"state": "OR",
"postal_code": "974771047",
"telephone_number": "541-341-8063",
"fax_number": "541-341-8099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 INTERNATIONAL WAY",
"city": "SPRINGFIELD",
"state": "OR",
"postal_code": "974771047",
"telephone_number": "541-341-8063",
"fax_number": "541-341-8099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINI",
"first_name": "JAYANTHI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-02",
"last_updated": "2011-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "WA",
"license": "MD00038975",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "OR",
"license": "MD152979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.