Individual provider Active NPI

Victoria L Kinsey, DO

  • Family Medicine Physician
  • Benton, TN
National Provider Identifier
1225023799
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2224 Issued in TN
Practice address
6784 Highway 411
Benton, TN 37307-4818
Phone
(423) 472-2273
Fax
(423) 472-2737
NPI assigned
Sep 12, 2005
Last updated
Feb 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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 2224 TN Primary

Addresses

Primary practice location

6784 Highway 411
Benton, TN 37307-4818

Mailing address

PO Box 308
Benton, TN 37307-0308
Phone (423) 338-8995

Other names 1

  • Vicki L Folsom Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20150424000767 TN Practitioner - Family Practice 4880583053 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2224TNMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kaful Double Portion Family Practice, Inc CurrentSince Mar 21, 2020 Accepting new patients
Ocoee Regional Health Corporation CurrentSince Oct 17, 2018 Accepting new patients
Ocoee Regional Health Corporation CurrentSince Oct 17, 2018 Accepting new patients

Locations

1420 Fritz St SE
Cleveland, TN 37323
Phone (423) 380-6383

3740 Ocoee Pl NW
Ste 101
Cleveland, TN 37312
Phone (423) 339-7107

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1225023799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "BENTON",
            "state": "TN",
            "postal_code": "373070308",
            "telephone_number": "423-338-8995",
            "fax_number": "423-338-8996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6784 HIGHWAY 411",
            "city": "BENTON",
            "state": "TN",
            "postal_code": "373074818",
            "telephone_number": "423-472-2273",
            "fax_number": "423-472-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSEY",
        "first_name": "VICTORIA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "2224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICKI",
            "last_name": "FOLSOM",
            "middle_name": "L",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Benton, TN

Sources for this page

Verify at the official NPI Registry.