Individual provider Active NPI

Kaylee Maunz, NP

  • Adult Health Nurse Practitioner
  • North Chesterfield, VA
National Provider Identifier
1043054521
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0024191580 Issued in VA
Practice address
1401 Johnston Willis Dr Ste 100
North Chesterfield, VA 23235-4730
Phone
(804) 330-7990
Fax
(804) 330-2701
NPI assigned
Jun 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0024191580 VA Primary
Registered Nurse 163W00000X 0001292107 VA

Addresses

Primary practice location

1401 Johnston Willis Dr Ste 100
North Chesterfield, VA 23235-4730

Mailing address

7202 Glen Forest Dr Ste 200
Richmond, VA 23226-3780
Phone (804) 673-2024

Other practice location 1

6130 Harbourside Centre Loop
Midlothian, VA 23112-2104
Phone (804) 378-0394

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
I20250103002766 VA Practitioner - Nurse Practitioner 5496283434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Virginia School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1401 Johnston Willis Dr
North Chesterfield, VA 23235-4730
Phone (804) 330-7990

Hospital & facility affiliations

  • CJW Medical Center Hospital, Richmond, VA, CCN 490112

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001292107VAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Cancer Institute Incorporated CurrentSince Dec 4, 2024 Accepting new patients
Virginia Cancer Institute Incorporated CurrentSince Dec 4, 2024 Accepting new patients

Locations

1401 Johnston Willis Dr
Ste 100
North Chesterfield, VA 23235
Phone (804) 287-3000

7202 Glen Forest Dr
Ste 200
Richmond, VA 23226
Phone (804) 673-0134

Interoperability endpoints

  • FHIR API: https://fhir.prod.flatiron.io/fhir/

Organizations & group practices 2

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 1

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": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1043054521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7202 GLEN FOREST DR STE 200",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263780",
            "telephone_number": "804-673-2024",
            "fax_number": "804-673-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 JOHNSTON WILLIS DR STE 100",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354730",
            "telephone_number": "804-330-7990",
            "fax_number": "804-330-2701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6130 Harbourside Centre Loop",
            "address_purpose": "LOCATION",
            "city": "Midlothian",
            "state": "VA",
            "postal_code": "231122104",
            "country_code": "US",
            "telephone_number": "804-378-0394",
            "fax_number": "804-739-7649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAUNZ",
        "first_name": "KAYLEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024191580",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001292107",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

Verify at the official NPI Registry.