NPIMap

Individual provider Active NPI

Kim R McFadden, PA

  • Physician Assistant
  • Providence Forge, VA
National Provider Identifier
1295879963
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002478 Issued in VA
Practice address
9010 Pocahontas Trail
Providence Forge, VA 23140
Phone
(804) 966-5208
Fax
(804) 966-9712
NPI assigned
Feb 16, 2007
Last updated
Mar 13, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002478 VA Primary

Addresses

Primary practice location

9010 Pocahontas Trail
Providence Forge, VA 23140

Mailing address

PO Box 7
Quinton, VA 23141-0007
Phone (804) 932-1005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170804001028 GA Practitioner - Physician Assistant 2466547641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as group
Quality
83.37
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chickahominy Family Past Accepting new patients
Loon Emergency Physicians LLC Past Accepting new patients
Virginia Emergency Physicians LLP Past Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Columbia Healthcare of Central Virginia Inc PastSince Apr 1, 2019 Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Mount Lassen Emergency Physicians LLC Past Accepting new patients
Lavender Inpatient Services LLC Past Accepting new patients

Organizations & group practices 11

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1295879963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7",
            "city": "QUINTON",
            "state": "VA",
            "postal_code": "231410007",
            "telephone_number": "804-932-1005",
            "fax_number": "804-932-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9010 POCAHONTAS TRAIL",
            "city": "PROVIDENCE FORGE",
            "state": "VA",
            "postal_code": "23140",
            "telephone_number": "804-966-5208",
            "fax_number": "804-966-9712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCFADDEN",
        "first_name": "KIM",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence Forge, VA

Sources for this page

Verify at the official NPI Registry.