NPIMap

Organization Active NPI

SE Virginia Value Based Care, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Norfolk, VA
National Provider Identifier
1225720501
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
SE VIRGINIA VALUE BASED CARE, LLC
Practice address
6160 Kempsville Cir Ste 325a
Norfolk, VA 23502-3933
Phone
(757) 354-2885
Fax
(757) 917-5141
NPI assigned
May 24, 2023
Last updated
Jun 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Authorized official

Name
Christine Kroetsch
Title
Practice Administrator
Phone
(757) 917-5246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU Primary

Addresses

Primary practice location

6160 Kempsville Cir Ste 325a
Norfolk, VA 23502-3933

Mailing address

6160 Kempsville Cir Ste 325a
Norfolk, VA 23502-3933
Phone (757) 354-2885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230809000204 VA Part B Supplier - Clinic/Group Practice 6103288170 Receives reassigned benefits from 228 practitioners
Practice locations: Norfolk, VA

National Provider Directory

National Provider Directory

Locations

1000 Old Denbigh Blvd
Newport News, VA 23602
Phone (757) 827-7003

6160 Kempsville Cir
Ste 325A
Norfolk, VA 23502
Phone (757) 354-2885

Practitioners & affiliated clinicians

Practitioners 230

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 230

NPI Registry JSON

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1225720501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6160 KEMPSVILLE CIR STE 325A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023933",
            "telephone_number": "757-354-2885",
            "fax_number": "757-917-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 KEMPSVILLE CIR STE 325A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023933",
            "telephone_number": "757-354-2885",
            "fax_number": "757-917-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SE VIRGINIA VALUE BASED CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "KROETSCH",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "757-917-5246"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.