Individual provider Active NPI

Kathryn Marie Klump, ANP

  • Adult Health Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1093736464
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0024166961 Issued in VA
Practice address
1101 First Colonial Rd
Suite 300
Virginia Beach, VA 23454-2409
Phone
(757) 481-4817
Fax
(757) 481-7138
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0024166961 VA Primary

Addresses

Primary practice location

1101 First Colonial Rd
Suite 300
Virginia Beach, VA 23454-2409

Mailing address

1717 Will O'Wisp Drive
Suite 200
Virginia Beach, VA 23454
Phone (757) 481-4817

Other names 1

  • Mrs. Kathryn Marie Carpenter Former name

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
I20070102000484 VA Practitioner - Nurse Practitioner 8123028800 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Johns Hopkins University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SE Virginia Value Based Care LLCGroup PAC ID 6103288170, 160 clinicians
Mid-Atlantic Post Acute and Long Term Care PLLCGroup PAC ID 0648530782, 142 clinicians

Practice addresses (Care Compare)

Norfolk, VA 23502
Phone (757) 354-2885

6160 Kempsville Cir
Suite 325a
Norfolk, VA 23502-3933
Phone (757) 354-2885

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024166961VAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Post Acute & Long Term Care PLLC Adult Health CurrentSince Jul 11, 2022 Accepting new patients
SE Virginia Value Based Care, LLC CurrentSince Aug 1, 2023 Accepting new patients
Joseph B Hollis MD PC PastSince Aug 22, 2010 Accepting new patients

Locations

6160 Kempsville Cir
Ste 325A
Norfolk, VA 23502
Phone (757) 354-2885

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1093736464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 WILL O'WISP DRIVE",
            "address_2": "SUITE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23454",
            "telephone_number": "757-481-4817",
            "fax_number": "757-481-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 FIRST COLONIAL RD",
            "address_2": "SUITE 300",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542409",
            "telephone_number": "757-481-4817",
            "fax_number": "757-481-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUMP",
        "first_name": "KATHRYN",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024166961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "CARPENTER",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "credential": "ANP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.