Individual provider Active NPI

Kathryn Simpson Mabe, PA

  • Physician Assistant
  • Roanoke, VA
National Provider Identifier
1134314727
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002606 Issued in VA
Practice address
3707 Brambleton Ave
Roanoke, VA 24018-3658
Phone
(540) 725-7800
Fax
(540) 989-6752
NPI assigned
Sep 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002606 VA Primary

Addresses

Primary practice location

3707 Brambleton Ave
Roanoke, VA 24018-3658

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5715

Other identifiers 1

IdentifierTypeStateIssuer
0110002606OtherVALICENSE

Other names 1

  • Ms. Kathryn Elizabeth Simpson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmabe14273@direct.carilionclinic.org Direct

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
I20071107000787 VA Practitioner - Physician Assistant 1557458528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians

Practice addresses (Care Compare)

150 Market Ridge LN
Daleville, VA 24083-3258
Phone (540) 966-0400

3707 Brambleton Ave SW
2 Carilion Family Medicine Brambleton
Roanoke, VA 24018-3658
Phone (540) 725-7800

6415 Peters Creek Rd
Roanoke, VA 24019-4021
Phone (703) 562-2110

Hospital & facility affiliations

  • Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation CurrentSince Aug 27, 2007 Accepting new patients
Carilion Healthcare Corporation CurrentSince Aug 27, 2007 Accepting new patients

Locations

3707 Brambleton Ave
Roanoke, VA 24018
Phone (540) 725-7800

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

Interoperability endpoints

  • Direct secure messaging: kmabe14273@direct.carilionclinic.org

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.

Hospital & facility affiliations 1

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": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1134314727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713",
            "telephone_number": "540-224-5715",
            "fax_number": "540-224-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183658",
            "telephone_number": "540-725-7800",
            "fax_number": "540-989-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABE",
        "first_name": "KATHRYN",
        "middle_name": "SIMPSON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0110002606",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmabe14273@direct.carilionclinic.org",
            "affiliation": "N",
            "endpointDescription": "kmabe14273@direct.carilionclinic.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3707 Brambleton Ave",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240183658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "SIMPSON",
            "middle_name": "ELIZABETH",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.