Individual provider Active NPI

Kathryn J Jaquette, F.N.P

  • Family Nurse Practitioner
  • Charlottesville, VA
National Provider Identifier
1174536791
Registry record updated Nov 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024055092 Issued in VA
Practice address
3025 Berkmar Dr
Suite 1
Charlottesville, VA 22901-1456
Phone
(434) 973-1831
Fax
(434) 973-1919
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2011

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 0024055092 VA Primary

Addresses

Primary practice location

3025 Berkmar Dr
Suite 1
Charlottesville, VA 22901-1456

Mailing address

3025 Berkmar Dr
Suite 1
Charlottesville, VA 22901-1456
Phone (434) 973-1831

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
I20110429000419 VA Practitioner - Nurse Practitioner 1951586288 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024055092VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Mar 15, 2016 Accepting new patients
Privia Medical Group, LLC CurrentSince Mar 15, 2016 Accepting new patients

Locations

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

3025 Berkmar Dr
Ste 1
Charlottesvle, VA 22901
Phone (434) 973-1831

3025 Berkmar Dr
Charlottesvle, VA 22901
Phone (434) 973-1831

8644 Sudley Rd
#220
Manassas, VA 20110

7605 Forest Ave
Ste 316
Richmond, VA 23229
Phone (804) 282-0044

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.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320624000000",
    "number": "1174536791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 BERKMAR DR",
            "address_2": "SUITE 1",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229011456",
            "telephone_number": "434-973-1831",
            "fax_number": "434-973-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 BERKMAR DR",
            "address_2": "SUITE 1",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229011456",
            "telephone_number": "434-973-1831",
            "fax_number": "434-973-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAQUETTE",
        "first_name": "KATHRYN",
        "middle_name": "J",
        "credential": "F.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2011-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024055092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.