Individual provider Active NPI

Kevin Edward Todd Jr., MD

  • Pediatric Hematology & Oncology Physician
  • Cincinnati, OH
National Provider Identifier
1073909958
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
0101271650 Issued in VA
Practice address
3333 Burnet Ave # 5012
Cincinnati, OH 45229
Phone
(757) 668-9763
Fax
(757) 668-9766
NPI assigned
Apr 8, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Hematology & Oncology Physician 2080P0207X 0101271650 VA Primary

Addresses

Primary practice location

3333 Burnet Ave # 5012
Cincinnati, OH 45229

Mailing address

1701 Dalwood Mews
Virginia Beach, VA 23455-4369
Phone (757) 763-8413

Other practice location 1

601 Childrens Ln
Norfolk, VA 23507-1971
Phone (757) 668-2233

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210622002988 VA Practitioner - Hematology/OncologyPractitioner - Pediatric Medicine 8628378064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Pediatric Medicine
Education
Eastern Virginia Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Specialty Group PLLCGroup PAC ID 5890788764, 89 clinicians

Practice addresses (Care Compare)

601 Childre'S LN
Norfolk, VA 23507-1910
Phone (757) 668-7007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101271650VAMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Specialty Group PLLC CurrentSince Jul 1, 2021 Accepting new patients

Locations

11783 Rock Landing Dr
Newport News, VA 23606
Phone (757) 668-6550

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1073909958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 DALWOOD MEWS",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234554369",
            "telephone_number": "757-763-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE # 5012",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45229",
            "telephone_number": "757-668-9763",
            "fax_number": "757-668-9766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Childrens Ln",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071971",
            "country_code": "US",
            "telephone_number": "757-668-2233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TODD",
        "first_name": "KEVIN",
        "middle_name": "EDWARD",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-08",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "VA",
            "license": "0101271650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.