Individual provider Active NPI

Jessica Joline Kvasnicka, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Beaumont, TX
National Provider Identifier
1861199531
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1111563 Issued in TX
Practice address
3195 Dowlen Rd Ste 101-524
Beaumont, TX 77706-7271
Phone
(432) 978-7612
NPI assigned
Feb 13, 2023
Last updated
Mar 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1111563 TX Primary
Registered Nurse 163W00000X 763704 TX

Addresses

Primary practice location

3195 Dowlen Rd Ste 101-524
Beaumont, TX 77706-7271

Mailing address

10008 Pilot Ave
Midland, TX 79706-2615
Phone (432) 978-7612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250205002521 TX Practitioner - Nurse Practitioner 3476083544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Texas Tech University Health Science Center School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Winnie Community Hospital LLCGroup PAC ID 3375440894, 23 clinicians

Practice addresses (Care Compare)

3560 Delaware St
Suite 502
Beaumont, TX 77706-3061
Phone 4092321500217

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1111563TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitality Health and Wellness LLC Psychiatric/Mental Health CurrentSince Jun 21, 2026 Accepting new patients
Winnie Community Hospital LLC CurrentSince Nov 13, 2024 Accepting new patients
Winnie Community Hospital, L.L.C. CurrentSince Nov 13, 2024 Accepting new patients
The Samaritan Counseling Center of West Texas Inc PastSince Mar 5, 2023 Accepting new patients

Locations

3195 Dowlen Rd
Ste 101524
Beaumont, TX 77706
Phone (432) 978-7612

3560 Delaware St
Ste 502
Beaumont, TX 77706
Phone (409) 899-4472

2400 Highway 365
Ste 112
Nederland, TX 77627
Phone (409) 284-9717

538 Broadway
Winnie, TX 77665
Phone (409) 296-6000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1861199531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10008 PILOT AVE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797062615",
            "telephone_number": "432-978-7612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3195 DOWLEN RD STE 101-524",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777067271",
            "telephone_number": "432-978-7612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KVASNICKA",
        "first_name": "JESSICA",
        "middle_name": "JOLINE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1111563",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "763704",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.