Jessica Danielle Blackwill (NPI# 1114584802, PAC ID# 3577899616) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1114584802 |
| PAC ID by PECOS | 3577899616 |
| Professional Enrollment ID | I20190726000236 |
| Full Name | Jessica Danielle Blackwill |
| Organization Legal Name | NINNESCAH VALLEY HEALTH SYSTEMS INC |
| Address |
750 W D Ave Kingman KS 67068-1266 |
| Phone Number | 6205323147 |
| Gender | F |
| Graduation Year | 2019 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 5799683694 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 171378 | KINGMAN COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 750 W D Ave, Kingman, KS 67068-1266 | 6205323147 | NINNESCAH VALLEY HEALTH SYSTEMS INC |
| Organization Legal Name | NINNESCAH VALLEY HEALTH SYSTEMS INC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kathleen L Smith | Nurse Practitioner | Ninnescah Valley Health Systems Inc | 750 W D Ave, Kingman, KS 67068-1266 |
| Cherie L Morris | Family Medicine | Ninnescah Valley Health Systems Inc | 750 W D Ave, Kingman, KS 67068-1266 |
| Ina M Fairchild | Physician Assistant | Ninnescah Valley Health Systems Inc | 750 W D Ave, Kingman, KS 67068-1266 |
| Amy Renee Miller | Nurse Practitioner | Ninnescah Valley Health Systems Inc | 750 W D Ave, Kingman, KS 67068-1266 |
| Erin Baxa | Family Medicine | Ninnescah Valley Health Systems Inc | 760 W D Ave, Kingman, KS 67068-1222 |
| Carl L Green | Physician Assistant | Ninnescah Valley Health Systems Inc | 750 W D Ave, Kingman, KS 67068-1266 |
| Victoria M Moots | Family Medicine | Ninnescah Valley Health Systems Inc | 760 W D Ave, Kingman, KS 67068-1222 |
| Katherine J Cates Panakos | Family Medicine | Ninnescah Valley Health Systems Inc | 760 W D Ave, Kingman, KS 67068-1222 |
| Street Address |
750 W D AVE |
| City | KINGMAN |
| State | KS |
| Zip | 67068-1266 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Pronab K Sensarma | Cardiovascular Disease (cardiology) | 750 W D Ave, Kingman, KS 67068-1266 | |
| Kathleen L Smith | Nurse Practitioner | Ninnescah Valley Health Systems Inc | 750 W D Ave, Kingman, KS 67068-1266 |
| Cherie L Morris | Family Medicine | Ninnescah Valley Health Systems Inc | 750 W D Ave, Kingman, KS 67068-1266 |
| Ina M Fairchild | Physician Assistant | Ninnescah Valley Health Systems Inc | 750 W D Ave, Kingman, KS 67068-1266 |
| Krishnaku M Kotecha | Diagnostic Radiology | 750 W D Ave, Kingman, KS 67068-1266 | |
| Amy Renee Miller | Nurse Practitioner | Ninnescah Valley Health Systems Inc | 750 W D Ave, Kingman, KS 67068-1266 |
| Carl L Green | Physician Assistant | Ninnescah Valley Health Systems Inc | 750 W D Ave, Kingman, KS 67068-1266 |
| Thomas L Ashcom | Cardiovascular Disease (cardiology) | Thomas L Ashcom Md Phd Pa | 750 W D Ave, Kingman, KS 67068-1266 |
| Marsha R Stineman | Certified Registered Nurse Anesthetist (crna) | 750 W D Ave, Kingman, KS 67068-1266 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Seth A Thibault | Optometry | Maydew Thibault Optometry LLC | 104 W Ave C, Kingman, KS 67068 |
| Randall R Beech | General Surgery | 750 Ave D W, Kingman, KS 67068 | |
| Andrew W Piester | Optometry | Maydew Thibault Optometry LLC | 104 W Ave C, Kingman, KS 67068 |
| Kevin R Martin Nisly | Clinical Social Worker | Horizons Mental Health Center, Inc. | 760 W D Ave, Suite 1, Kingman, KS 67068-0227 |
| Margaret E Akins | Clinical Social Worker | Horizons Mental Health Center, Inc. | 760 W D Ave, Suite 1, Kingman, KS 67068-0227 |
| Erin Baxa | Family Medicine | Ninnescah Valley Health Systems Inc | 760 W D Ave, Kingman, KS 67068-1222 |
| Victoria M Moots | Family Medicine | Ninnescah Valley Health Systems Inc | 760 W D Ave, Kingman, KS 67068-1222 |
| Katherine J Cates Panakos | Family Medicine | Ninnescah Valley Health Systems Inc | 760 W D Ave, Kingman, KS 67068-1222 |
| Joshua A Reed | Nurse Practitioner | Cancer Center of Kansas.p.a. | 750 Ave D W, Kingman, KS 67068-1266 |
| Kimberly D Widler | Nurse Practitioner | Cancer Center of Kansas.p.a. | 750 Ave D W, Kingman, KS 67068-1266 |
| Find all physicians in zip 67068 | |||
| City | KINGMAN |
| Zip Code | 67068 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | KINGMAN + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.