Kevaghn P. Fair, D.O.

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

License

0102050191 Issued in VA

Practice address

733 Boush St
Suite 200
Norfolk, VA 23510-1501

Phone

(757) 664-7901

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Peninsula Pathology Associates Incorporated

  • Anatomic Pathology & Clinical Pathology Physician
  • Newport News, VA
  • NPI 1306834858
  NPD
• Dominion Pathology Laboratories PC

  • Clinical Medical Laboratory
  • Norfolk, VA
  • NPI 1740227115
  NPD (past)

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297382400000",
    "number": "1285694042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2453",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235012453",
            "telephone_number": "757-664-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 BOUSH ST",
            "address_2": "SUITE 200",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101501",
            "telephone_number": "757-664-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIR",
        "first_name": "KEVAGHN",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2011-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "VA",
            "license": "0102050191",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "0102050191",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4991427",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chinenye Ogechukwu Ezedike, MD
• Rachel Marie Faber, MD
• Jenifer Ann Fahey
• Mayar Fahim, DPM
• Rhonda L Fahringer, PA
• Amy E Faison, FNP-C
• Faith & Family Home Care LLC
• Faith LLC
• Faithandlove Medical Transportation and Group Home LLC
• Faithful Medical Transportation

• Dermatopathology (Pathology) Physician in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Dermatopathology (Pathology) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.