Individual provider Active NPI

Kira Marie Bleecher, M.D.

  • Psychiatry Physician
  • Glen Allen, VA
National Provider Identifier
1164868469
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
55739 Issued in CT
Practice address
4212 Park Place CT
Glen Allen, VA 23060-3314
Phone
(804) 332-5950
Fax
(804) 728-1086
NPI assigned
May 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 101265154 VA
Psychiatry Physician 2084P0800X 55739 CT Primary

Addresses

Primary practice location

4212 Park Place CT
Glen Allen, VA 23060-3314

Mailing address

4212 Park Place CT
Glen Allen, VA 23060-3314
Phone (804) 332-5950

Other names 1

  • Dr. Kira Marie Friedel 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190306000371 VA Practitioner - Addiction MedicinePractitioner - Psychiatry 4385983568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Addiction MedicineAlso: Psychiatry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virginia Center for Addiction MedicineGroup PAC ID 4789960055, 16 clinicians

Practice addresses (Care Compare)

2208 Executive Dr
Suite E
Hampton, VA 23666-6603
Phone (804) 332-5950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
101265154VAMDAddiction Medicine (Psychiatry & Neurology) Physician
55739CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Center for Addiction Medicine Addiction Medicine CurrentSince Dec 15, 2018 Accepting new patients

Locations

4212 Park Place Ct
Glen Allen, VA 23060
Phone (804) 332-5950

6760 Main St
Ste C
Gloucester, VA 23061
Phone (804) 332-5950

6760 Main St
Gloucester, VA 23061
Phone (804) 693-3500

2208 Executive Dr
Ste E
Hampton, VA 23666
Phone (757) 826-7516

25 W Water St
Harrisonburg, VA 22801
Phone (540) 433-5431

95 Harris Rd
Bldg 6
Kilmarnock, VA 22482
Phone (804) 332-5950

2505 Pocoshock Pl
Ste 101
North Chesterfield, VA 23235
Phone (804) 332-5950

2301 N Parham Rd
Ste 4
Richmond, VA 23229

289 Hospital Rd
Tappahannock, VA 22560
Phone (804) 332-5950

Organizations & group practices 1

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": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1164868469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 PARK PLACE CT",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603314",
            "telephone_number": "804-332-5950",
            "fax_number": "804-728-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 PARK PLACE CT",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603314",
            "telephone_number": "804-332-5950",
            "fax_number": "804-728-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEECHER",
        "first_name": "KIRA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-14",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "VA",
            "license": "101265154",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "55739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRA",
            "last_name": "FRIEDEL",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glen Allen, VA

Sources for this page

Verify at the official NPI Registry.