Individual provider Active NPI

Kristie F McDowell, PA-C

  • Medical Physician Assistant
  • King George, VA
National Provider Identifier
1275574279
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110001953 Issued in VA
Practice address
11131 Journal Parkway
King George, VA 22485
Phone
(540) 775-8009
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110001953 VA Primary

Addresses

Primary practice location

11131 Journal Parkway
King George, VA 22485

Mailing address

2602 Melissa CT
Fredericksburg, VA 22408-8069
Phone (540) 899-8877

Other identifiers 2

IdentifierTypeStateIssuer
010284872MedicaidVA
P00237442OtherRAILROAD MEDICARE

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
I20050706001020 VA Practitioner - Physician Assistant 5092751594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colonial Internal Medicine Associates PCGroup PAC ID 6608842521, 18 clinicians

Practice addresses (Care Compare)

125 Olde Greenwich Dr
Fredericksburg, VA 22408-4008
Phone (540) 374-5599

392 Garrisonville Rd
Suite 106
Stafford, VA 22554-1500
Phone (540) 374-5599

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110001953VAMDMedical Physician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240185600000",
    "number": "1275574279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 MELISSA CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224088069",
            "telephone_number": "540-899-8877",
            "fax_number": "540-735-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11131 JOURNAL PARKWAY",
            "city": "KING GEORGE",
            "state": "VA",
            "postal_code": "22485",
            "telephone_number": "540-775-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOWELL",
        "first_name": "KRISTIE",
        "middle_name": "F",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2009-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110001953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010284872",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00237442",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in King George, VA

Sources for this page

Verify at the official NPI Registry.