Individual provider Active NPI

Jeffrey Keith Arbuckle, M.D.

  • Family Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1205842887
Registry record updated Dec 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101222201 Issued in VA
Practice address
2859 Virginia Beach Blvd Ste 108
Virginia Beach, VA 23452-7622
Phone
(757) 644-4615
Fax
(757) 440-3921
NPI assigned
Aug 1, 2006
Last updated
Dec 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101222201 VA Primary

Addresses

Primary practice location

2859 Virginia Beach Blvd Ste 108
Virginia Beach, VA 23452-7622

Mailing address

2859 Virginia Beach Blvd Ste 108
Virginia Beach, VA 23452-7622
Phone (757) 644-4615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 27, 2015 through Oct 27, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101222201VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Total Hormone Replacement CurrentSince Oct 11, 2020 Accepting new patients
Sentara Life Care Corporation Past Accepting new patients
Arbuckle Dental PC PastSince Sep 25, 2021 Accepting new patients

Locations

2859 Virginia Beach Blvd
Ste 108
Virginia Beach, VA 23452
Phone (757) 472-0630

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1205842887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2859 VIRGINIA BEACH BLVD STE 108",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527622",
            "telephone_number": "757-644-4615",
            "fax_number": "757-440-3921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2859 VIRGINIA BEACH BLVD STE 108",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527622",
            "telephone_number": "757-644-4615",
            "fax_number": "757-440-3921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARBUCKLE",
        "first_name": "JEFFREY",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101222201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.