Jennifer Knisely, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2018069770 Issued in CA

Practice address

610 Euclid Ave Ste 200
National City, CA 91950-2951

Phone

(619) 267-9257

Fax

(619) 267-9273

NPI assigned

Dec 6, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

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.

• Ehab Yacoub MD Inc.

  • Child & Adolescent Psychiatry Physician
  • Gardena, CA
  • NPI 1417373713
  Medicare reassignment NPD
• Mellow Medical Inc a Professional Corporation

  • Psychiatry Physician
  • West Hollywood, CA
  • NPI 1407275886
  Medicare reassignment NPD
• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Advanced TMS Clinic Inc

  • Clinic/Center
  • National City, CA
  • NPI 1386104263
  NPD

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1992276679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 E 8TH ST STE 111",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502861",
            "telephone_number": "619-267-9257",
            "fax_number": "619-267-9273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 EUCLID AVE STE 200",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502951",
            "telephone_number": "619-267-9257",
            "fax_number": "619-267-9273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNISELY",
        "first_name": "JENNIFER",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-06",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "2018069770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "678055",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brendan Kidder, MD
• Jeannie G Kim, MD
• Kyung Chul Kim, M.D.
• Justin Benard King, MD
• Kellyann Knight, CRNP
• Latania Knox
• Anita Koo, O.D.
• Nathaniel Benjamin Kopka, BT
• Allison Kornblatt, M.D.
• Zoe Rebecca Kornweibel, CPSS

• Psychiatric/Mental Health Nurse Practitioner in National City, CA
• Providers in National City, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.