NPIMap

Individual provider Active NPI

Brenda Jean Kozak, FNP-C

  • Family Nurse Practitioner
  • Madison Heights, VA
National Provider Identifier
1104378744
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024174182 Issued in VA
Practice address
109 Clearview Rd
Madison Heights, VA 24572-2600
Phone
(434) 929-1400
NPI assigned
Oct 31, 2016
Last updated
May 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024174182 VA Primary

Addresses

Primary practice location

109 Clearview Rd
Madison Heights, VA 24572-2600

Mailing address

134 Elon Rd
Madison Heights, VA 24572-2536
Phone (434) 929-1400

Other practice location 1

134 Elon Rd
Madison Heights, VA 24572-2536
Phone (434) 929-1400

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
I20170504000578 VA Practitioner - Nurse Practitioner 3971880774 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Johnson Health CenterGroup PAC ID 9537060413, shared by 5 NPIs, 39 clinicians

Practice addresses (Care Compare)

109 Clearview Rd
Madison Heights, VA 24572-2600
Phone (434) 455-2480

200 Amelon SQ
Madison Heights, VA 24572-5981
Phone (434) 929-1400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson Health Center Current Accepting new patients
Johnson Health Center CurrentSince Nov 26, 2018 Accepting new patients
Johnson Health Center Past Accepting new patients

Locations

320 Federal St
Lynchburg, VA 24504
Phone (434) 947-5967

109 Clearview Rd
Madison Heights, VA 24572
Phone (434) 929-1400

134 Elon Rd
Madison Hts, VA 24572
Phone (434) 929-1400

925 Village Hwy
Rustburg, VA 24588
Phone (434) 332-7367

Interoperability endpoints

  • Direct secure messaging: brenda.kozak@jhc.eclinicaldirectplus.com

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 9

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": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1104378744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 ELON RD",
            "city": "MADISON HEIGHTS",
            "state": "VA",
            "postal_code": "245722536",
            "telephone_number": "434-929-1400",
            "fax_number": "434-455-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CLEARVIEW RD",
            "city": "MADISON HEIGHTS",
            "state": "VA",
            "postal_code": "245722600",
            "telephone_number": "434-929-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "134 Elon Rd",
            "address_purpose": "LOCATION",
            "city": "Madison Heights",
            "state": "VA",
            "postal_code": "245722536",
            "country_code": "US",
            "telephone_number": "434-929-1400",
            "fax_number": "434-455-2487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "BRENDA",
        "middle_name": "JEAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-31",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison Heights, VA

Sources for this page

Verify at the official NPI Registry.