NPIMap

Organization Active NPI

Kenneth a Siegel, PH.D., PC

  • Clinical Psychologist
  • Virginia Beach, VA
National Provider Identifier
1265608087
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810000887 Issued in VA
Legal business name
KENNETH A SIEGEL, PH.D., PC
Practice address
933 First Colonial Rd
Suite 201
Virginia Beach, VA 23454-3172
Phone
(757) 422-9733
Fax
(757) 422-4078
NPI assigned
May 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Authorized official

Name
Dr. Kenneth A Siegel, PH.D.
Title
President
Phone
(757) 422-9733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 0810000887 VA Primary

Addresses

Primary practice location

933 First Colonial Rd
Suite 201
Virginia Beach, VA 23454-3172

Mailing address

933 First Colonial Rd
Suite 201
Virginia Beach, VA 23454-3172
Phone (757) 422-9733

Other identifiers 5

IdentifierTypeStateIssuer
620000012OtherVAMEDICARE
083028OtherVASENTARA
006215OtherVAANTHEM BLUE CROSS/BLUE SHIELD
7714203MedicaidVA
4107739OtherVAAETNA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1265608087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 FIRST COLONIAL RD",
            "address_2": "SUITE 201",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543172",
            "telephone_number": "757-422-9733",
            "fax_number": "757-422-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 FIRST COLONIAL RD",
            "address_2": "SUITE 201",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543172",
            "telephone_number": "757-422-9733",
            "fax_number": "757-422-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH A SIEGEL, PH.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-01",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-422-9733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810000887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "620000012",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA",
            "identifier": "083028",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS/BLUE SHIELD",
            "identifier": "006215",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7714203",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4107739",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.