Kristin Dermody Maggi, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110003427 Issued in VA

Practice address

3700 Joseph Siewick Dr
Suite 308
Fairfax, VA 22033-1744

Phone

(703) 698-8960

Fax

(703) 716-8703

NPI assigned

Oct 20, 2010

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

Other names 1

• Ms. Kristin Dermody Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Old Dominion Anesthesia LLC

  • Anesthesiology Physician
  • Charlottesville, VA
  • NPI 1902248677
  NPD (past)

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1003126285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DR",
            "address_2": "SUITE 308",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331744",
            "telephone_number": "703-698-8960",
            "fax_number": "703-716-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DR",
            "address_2": "SUITE 308",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331744",
            "telephone_number": "703-698-8960",
            "fax_number": "703-716-8703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGGI",
        "first_name": "KRISTIN",
        "middle_name": "DERMODY",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110003427",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-02818",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA056117",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "DERMODY",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erika Frantz Madison, PH.D.
• Sergio Madrid, PT, DPT
• Leesa M Madsen, PA
• Danielle Magagnoli
• Alexandra Kathleen Magee, DNP, FNP-BC
• Michele Zerah Magnino, MD
• Magnolia Educational Services
• Alka Mahajan, DMD
• Sajan T Mahajan, MD
• Kathleen Mahan

• Medical Physician Assistant in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.