NPIMap

Individual provider Active NPI

Kiara Camila Douglas, PA-C

  • Medical Physician Assistant
  • Lynchburg, VA
National Provider Identifier
1073402707
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110011293 Issued in VA
Practice address
2405 Atherholt Rd
Lynchburg, VA 24501-2184
Phone
(434) 363-4133
NPI assigned
Jun 30, 2025
Last updated
Jan 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110011293 VA Primary

Addresses

Primary practice location

2405 Atherholt Rd
Lynchburg, VA 24501-2184

Mailing address

1810 Broadway St Unit 102
Lynchburg, VA 24501-5605
Phone (757) 748-9035

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
I20260219001027 VA Practitioner - Physician Assistant 8426538265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthovirginia IncGroup PAC ID 0547157224, 570 clinicians

Practice addresses (Care Compare)

2405 Atherholt Rd
Lynchburg, VA 24501-2184
Phone (434) 485-8517

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110011293VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthovirginia, Inc. CurrentSince Jan 5, 2026 Accepting new patients
Orthovirginia, Inc CurrentSince Jan 5, 2026 Accepting new patients

Locations

14521 Forest Rd
Ste D
Forest, VA 24551
Phone (434) 485-8500

2405 Atherholt Rd
Lynchburg, VA 24501
Phone (434) 485-8500

8200 Meadowbridge Rd
Ste 200
Mechanicsville, VA 23116
Phone (804) 560-5595

Organizations & group practices 3

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 7

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": "1751241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1073402707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 BROADWAY ST UNIT 102",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245015605",
            "telephone_number": "757-748-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 ATHERHOLT RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012184",
            "telephone_number": "434-363-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "KIARA",
        "middle_name": "CAMILA",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-30",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110011293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.