Individual provider Active NPI

Patricia K Keenan, PA-C

  • Physician Assistant
  • Fredericksburg, VA
National Provider Identifier
1306918511
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110840751 Issued in VA
Practice address
3310 Fall Hill Ave
Fredericksburg, VA 22401-3000
Phone
(540) 373-4602
Fax
(540) 371-3487
NPI assigned
Nov 14, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 0110840751 VA Primary

Addresses

Primary practice location

3310 Fall Hill Ave
Fredericksburg, VA 22401-3000

Mailing address

3310 Fall Hill Ave
Fredericksburg, VA 22401-3000
Phone (540) 373-4602

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
I20060510000597 VA Practitioner - Physician Assistant 4789695388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-1100

1301 Sam Perry Blvd
Suite 200
Fredericksburg, VA 22401-8420
Phone (540) 373-4602

2300 Fall Hill Ave
Suite 308
Fredericksburg, VA 22401-3343

3310 Fall Hill Ave
Fredericksburg, VA 22401-3000
Phone (540) 373-4602

4710 Spotsylvania Pkwy
Fredericksburg, VA 22407-9433

90 Greenspring Dr
Stafford, VA 22554-1752
Phone (540) 373-4602

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110840751VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Physicians CurrentSince Aug 19, 2019 Accepting new patients
Pratt Medical Center LTD Past Accepting new patients

Locations

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

3310 Fall Hill Ave
Fredericksburg, VA 22401
Phone (540) 373-7133

Interoperability endpoints

  • Direct secure messaging: pkeenan33438@marywashingtonhealthcare.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1306918511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 FALL HILL AVE",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013000",
            "telephone_number": "540-373-4602",
            "fax_number": "540-371-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 FALL HILL AVE",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013000",
            "telephone_number": "540-373-4602",
            "fax_number": "540-371-3487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "PATRICIA",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110840751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.