Jaclyn Nicole Kissel, CST

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

153288 Issued in IN

Practice address

520 Mary St Ste 520
Evansville, IN 47710-1682

Phone

(812) 424-8231

NPI assigned

Aug 22, 2019

Last updated

Feb 24, 2025By the provider in NPPES

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

Other identifiers 1

Other names 1

• Jaclyn N Adams Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71249

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.

• Evansville Surgical Associates Inc

  • Surgery Physician
  • Evansville, IN
  • NPI 1497707517

  Surgical Assistant

  NPD

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1992352165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MARY ST STE 520",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101682",
            "telephone_number": "812-424-8231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MARY ST STE 520",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101682",
            "telephone_number": "812-424-8231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSEL",
        "first_name": "JACLYN",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "CST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "IN",
            "license": "153288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATION",
            "identifier": "153288",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "ADAMS",
            "middle_name": "N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel Kirkman, DO
• Karissa L Kirkwood, CST
• Bernard W Kirsch, LCSW
• Jonathan Bernard Kirsch, DPT
• Joseph W Kirsch, LCSW
• Jody A Kissel, OTR/CHT
• Shauwney Le-Erin Kittinger, APRN
• Nicole Lee Kitzinger
• Lewis Kivett, PHARMD, RPH
• KJ Health Services LLC

• Surgical Assistant in Evansville, IN
• Providers in Evansville, IN by specialty
• Surgical Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.