Larry Howard Kagan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101032171 Issued in VA

Practice address

1016 Justis St
Chesapeake, VA 23325

Phone

(757) 420-8297

Fax

(757) 523-5639

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Mrs. Kimberley Koons Woloshin Professional name

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 Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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.

• Tidewater Physicians Multispecialty Group PC

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1902848294
  Medicare reassignment NPD
• Tidewater Physicians Multispecialty Group PC

  • Ambulatory Surgical Clinic/Center
  • Williamsburg, VA
  • NPI 1316790512
  NPD

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1326052986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 JUSTIS ST",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "23325",
            "telephone_number": "757-420-8297",
            "fax_number": "757-523-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 JUSTIS ST",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "23325",
            "telephone_number": "757-420-8297",
            "fax_number": "757-523-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAGAN",
        "first_name": "LARRY",
        "middle_name": "HOWARD",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101032171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5619165",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "011785",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA",
            "identifier": "11018",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLEY",
            "last_name": "WOLOSHIN",
            "middle_name": "KOONS",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• K3 Heart Services
• Kabafusion VA, LLC
• Lisa Kabalan, NP
• Humayun Kabir, PMHNP
• H Dennis Kade, PH.D.
• Patrice Kainrath, MA, CCC-SLP
• Kaitlyn Stephenson
• Andrew Kam, RPH
• Lilian M Kamau
• Brianna Ilene Kammer, LPN

• Family Medicine Physician in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; 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.