Individual provider Active NPI

Kaitlin Scott Daniels, PA-C

  • Physician Assistant
  • Salem, VA
National Provider Identifier
1033509088
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110-004845 Issued in VA
Practice address
100 Knotbreak Rd
Salem, VA 24153
Phone
(540) 444-5670
Fax
(540) 444-5669
NPI assigned
Jan 29, 2015
Last updated
Sep 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110-004845 VA Primary

Addresses

Primary practice location

100 Knotbreak Rd
Salem, VA 24153

Mailing address

100 Knotbreak Rd
Salem, VA 24153-5414
Phone (540) 444-5670

Other practice location 1

1802 Braeburn Dr Ste 3C10
Salem, VA 24153-7357
Phone (540) 444-5670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20150618001489 VA Practitioner - Physician Assistant 0547571424 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0110-004845VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Jul 6, 2020 Accepting new patients
Carilion Rockbridge Community Hospital CurrentSince Jul 6, 2020 Accepting new patients
Carilion Rockbridge Community Hospital CurrentSince Jul 6, 2020 Accepting new patients

Locations

1 Health Cir
Lexington, VA 24450
Phone (540) 458-3300

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

1802 Braeburn Dr
Ste 3C10
Salem, VA 24153
Phone (540) 444-5670

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ECEIBD
  • Direct secure messaging: kdaniels26471@direct.carilionclinic.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1033509088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KNOTBREAK RD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241535414",
            "telephone_number": "540-444-5670",
            "fax_number": "540-444-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KNOTBREAK RD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "24153",
            "telephone_number": "540-444-5670",
            "fax_number": "540-444-5669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1802 Braeburn Dr Ste 3C10",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "VA",
            "postal_code": "241537357",
            "country_code": "US",
            "telephone_number": "540-444-5670",
            "fax_number": "540-444-5669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "KAITLIN",
        "middle_name": "SCOTT",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-29",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-004845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

Verify at the official NPI Registry.