Individual provider Active NPI

Duane Kresge, NP

  • Pediatric Nurse Practitioner
  • Madison Heights, VA
National Provider Identifier
1104918887
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
300072 Issued in NC
Practice address
134 Elon Rd
Madison Heights, VA 24572-2536
Phone
(434) 455-2480
Fax
(434) 455-2487
NPI assigned
Sep 29, 2006
Last updated
May 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 300072 NC Primary

Addresses

Primary practice location

134 Elon Rd
Madison Heights, VA 24572-2536

Mailing address

134 Elon Rd
Madison Heights, VA 24572-2536
Phone (434) 455-2480

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
I20130219000449 VA Practitioner - Nurse Practitioner 0840445086 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
300072NCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson Health Center Current Accepting new patients
Johnson Health Center CurrentSince May 12, 2019 Accepting new patients
Johnson Health Center CurrentSince Aug 20, 2013 Accepting new patients

Locations

2402 Atherholt Rd
Lynchburg, VA 24501
Phone (434) 200-6401

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

Interoperability endpoints

  • Direct secure messaging: duane.kresge@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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1104918887",
    "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": "434-455-2480",
            "fax_number": "434-455-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 ELON RD",
            "city": "MADISON HEIGHTS",
            "state": "VA",
            "postal_code": "245722536",
            "telephone_number": "434-455-2480",
            "fax_number": "434-455-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRESGE",
        "first_name": "DUANE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "300072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison Heights, VA

Sources for this page

Verify at the official NPI Registry.