Individual provider Active NPI

Zoe D Kavanaugh

  • Audiologist
  • Woodbridge, VA
National Provider Identifier
1073996591
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2201001595 Issued in VA
Practice address
2070 Old Bridge Rd Ste 103
Woodbridge, VA 22192-2495
Phone
(703) 499-8787
Fax
(703) 499-8099
NPI assigned
Jul 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2201001595 VA Primary

Addresses

Primary practice location

2070 Old Bridge Rd Ste 103
Woodbridge, VA 22192-2495

Mailing address

2070 Old Bridge Rd Ste 103
Woodbridge, VA 22192-2495
Phone (703) 499-8787

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170531000781 TX Practitioner - Qualified Audiologist 7214204999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Head and Neck Surgical AssociatesGroup PAC ID 8022089622, 11 clinicians

Practice addresses (Care Compare)

1 Burnside
Wichita Falls, TX 76310-1123
Phone (940) 322-6953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2201001595VAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
United Regional Health Care System Inc Current Accepting new patients
Head & Neck Surgical Associates CurrentSince Sep 21, 2016 Accepting new patients

Locations

1 Burnside
Wichita Falls, TX 76310
Phone (940) 264-5500

Interoperability endpoints

  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/
  • Direct secure messaging: zkavanaugh23419@unitedregional.medalliesdirect.net
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1073996591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2070 OLD BRIDGE RD STE 103",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922495",
            "telephone_number": "703-499-8787",
            "fax_number": "703-499-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 OLD BRIDGE RD STE 103",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922495",
            "telephone_number": "703-499-8787",
            "fax_number": "703-499-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "ZOE",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.