NPIMap

Individual provider Active NPI

Kelly Oliver Spann, NP

  • Family Nurse Practitioner
  • Williamsburg, VA
National Provider Identifier
1003990441
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024165415 Issued in VA
Practice address
400 Sentara Cir Ste 320
Williamsburg, VA 23188-5716
Phone
(757) 345-4800
Fax
(757) 345-4801
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024165415 VA Primary

Addresses

Primary practice location

400 Sentara Cir Ste 320
Williamsburg, VA 23188-5716

Mailing address

400 Sentara Cir Ste 320
Williamsburg, VA 23188-5716
Phone (757) 345-4800

Other practice location 1

11803 Jefferson Ave Ste 205
Newport News, VA 23606-2565
Phone (757) 736-9860

Other practice location 2

5659 Parkway Dr Ste 200
Gloucester, VA 23061-3792
Phone (757) 345-4800

Other practice location 3

1250 E Marshall St
Dept. of Emergency Medicine
Richmond, VA 23298-5051
Phone (804) 828-0996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040407000859 VA Practitioner - Nurse Practitioner 8527051291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bon Secours Medical Group Hampton Roads Specialty Care LLCGroup PAC ID 3173955671, 197 clinicians

Practice addresses (Care Compare)

12720 McManus Blvd
Newport News, VA 23602-4414
Phone (757) 947-3170

150 Kingsley LN
Norfolk, VA 23505-4602
Phone (757) 398-2673

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Mary Immaculate Hospital LLC CurrentSince Aug 6, 2017 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Mary Immaculate Hospital LLC CurrentSince Aug 6, 2017 Accepting new patients

Locations

12720 McManus Blvd
Ste 308
Newport News, VA 23602
Phone (757) 947-3170

12720 McManus Blvd
Ste 311
Newport News, VA 23602
Phone (757) 872-0548

12720 McManus Blvd
Ste 305
Newport News, VA 23602
Phone (757) 947-3170

150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944

7007 Harbour View Blvd
Ste 108
Suffolk, VA 23435
Phone (757) 215-2784

Interoperability endpoints

  • Direct secure messaging: kspann1155984@direct.bsmhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1003990441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SENTARA CIR STE 320",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885716",
            "telephone_number": "757-345-4800",
            "fax_number": "757-345-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SENTARA CIR STE 320",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885716",
            "telephone_number": "757-345-4800",
            "fax_number": "757-345-4801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11803 Jefferson Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236062565",
            "country_code": "US",
            "telephone_number": "757-736-9860",
            "fax_number": "757-240-5537",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5659 Parkway Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Gloucester",
            "state": "VA",
            "postal_code": "230613792",
            "country_code": "US",
            "telephone_number": "757-345-4800",
            "fax_number": "757-510-9259",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 E Marshall St",
            "address_2": "Dept. of Emergency Medicine",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985051",
            "country_code": "US",
            "telephone_number": "804-828-0996",
            "fax_number": "804-628-0368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPANN",
        "first_name": "KELLY",
        "middle_name": "OLIVER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024165415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.