NPIMap

Individual provider Active NPI

Johnathan Paul Kinzer, MD

  • Emergency Medicine Physician
  • Portsmouth, VA
National Provider Identifier
1063909059
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101271529 Issued in VA
Practice address
3636 High St
Portsmouth, VA 23707-3236
Phone
(443) 717-0272
NPI assigned
Apr 16, 2018
Last updated
Apr 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 61599 TN
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 0101271529 VA Primary

Addresses

Primary practice location

3636 High St
Portsmouth, VA 23707-3236

Mailing address

975 E 3Rd St
Chattanooga, TN 37403-2147
Phone (423) 778-7628

Other practice location 1

100 Sentara Cir
Williamsburg, VA 23188-5713
Phone (757) 260-9235

Other practice location 2

975 E 3rd St
Chattanooga, TN 37403-2147
Phone (423) 778-7628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201207002949 TN Practitioner - Emergency Medicine 4284984675 Reassigns benefits to 1 organization
I20210702000501 VA Practitioner - Emergency Medicine 4284984675 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of South Carolina School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of TidewaterGroup PAC ID 5092618462, 167 clinicians

Practice addresses (Care Compare)

100 Sentara Cir
Williamsburg, VA 23188-5713
Phone (757) 984-6000

2800 Godwin Blvd
Suffolk, VA 23434-8038
Phone (757) 934-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.91 of 100Reported as group
Quality
78.72
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
97.87 of 100Reported as group
Quality
95.04
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
61599TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Tidewater Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Williamsburg Emergency Physicians Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. CurrentSince Jul 1, 2021 Accepting new patients
Tennessee River Physicians, PLLC Emergency Medicine Current Accepting new patients
Tennessee River Physicians, PLLC Emergency Medicine CurrentSince Oct 15, 2020 Accepting new patients
Tennessee River Physicians, PLLC Emergency Medicine CurrentSince Oct 15, 2020 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jul 1, 2021 Accepting new patients
Williamsburg Emergency Physicians Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Arnot Medical Services PLLC Emergency Medicine Past Accepting new patients

Locations

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

16931 Rankin Ave
Dunlap, TN 37327
Phone (423) 949-5100

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

3636 High St
Portsmouth, VA 23707
Phone (757) 398-2200

2800 Godwin Blvd
Suffolk, VA 23434
Phone (757) 363-6850

100 Sentara Cir
Williamsburg, VA 23188
Phone (678) 690-7826

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1063909059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032147",
            "telephone_number": "423-778-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 HIGH ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073236",
            "telephone_number": "443-717-0272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Sentara Cir",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231885713",
            "country_code": "US",
            "telephone_number": "757-260-9235",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "975 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374032147",
            "country_code": "US",
            "telephone_number": "423-778-7628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINZER",
        "first_name": "JOHNATHAN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-16",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "61599",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101271529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.