Individual provider Active NPI

Kathleen Marie Anderson, NP

  • Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1104157650
Registry record updated Oct 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024164345 Issued in VA
Practice address
2300 Dumbarton Rd
Richmond, VA 23228-6014
Phone
(804) 874-7949
NPI assigned
Jan 22, 2010
Last updated
Oct 2, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024164345 VA Primary
Acute Care Nurse Practitioner 363LA2100X 0024164345 VA

Addresses

Primary practice location

2300 Dumbarton Rd
Richmond, VA 23228-6014

Mailing address

PO Box 693
Midlothian, VA 23113-0693

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
I20120201000021 VA Practitioner - Nurse Practitioner 3375700446 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1989
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
0024164345VAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Post Acute & Long Term Care PLLC CurrentSince Sep 15, 2025 Accepting new patients
SE Virginia Value Based Care, LLC CurrentSince Sep 15, 2025 Accepting new patients

Locations

7602 Meredith Dr
Gloucester, VA 23061
Phone (804) 435-1684

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1104157650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 693",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231130693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 DUMBARTON RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232286014",
            "telephone_number": "804-874-7949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024164345",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024164345",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.