Paola Jetzabella Kennah, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9117136 Issued in FL

Practice address

2349 Village Square Pkwy Ste 110-111
Fleming Island, FL 32003-6355

Phone

(904) 385-2023

Fax

(904) 385-2454

NPI assigned

May 11, 2017

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

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

93.68 of 100Reported as group

Quality

82.26

Promoting interoperability

99

Improvement activities

40

Cost

76.32

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: paola.kennah.1@16446.direct.athenahealth.com

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1972030765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23343 NW COUNTY ROAD 236",
            "city": "HIGH SPRINGS",
            "state": "FL",
            "postal_code": "326439669",
            "telephone_number": "386-454-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2349 VILLAGE SQUARE PKWY STE 110-111",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320036355",
            "telephone_number": "904-385-2023",
            "fax_number": "904-385-2454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2925 DeBarr Rd Ste 240",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995082959",
            "country_code": "US",
            "telephone_number": "907-339-4650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4311 11th Ave NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98105",
            "country_code": "US",
            "telephone_number": "206-616-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNAH",
        "first_name": "PAOLA",
        "middle_name": "JETZABELLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9117136",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "139211",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JRC Fleming Island
• K & J Auto LLC
• Kadora Therapy Associates, LLC
• Lael Paschal Kaltz
• Shelby R Keller
• Elizabeth C. Kent, M.D.
• Niajah Kessler
• Barbara B Ketchum, LMHC LIC MENTAL HEAL
• Richard William Keys, PT
• Lilit Khaikin

• Physician Assistant in Fleming Island, FL
• Providers in Fleming Island, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.