Individual provider Active NPI

Katharine K Malbon, PA

  • Medical Physician Assistant
  • Virginia Beach, VA
National Provider Identifier
1326378746
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110003205 Issued in VA
Practice address
1120 First Colonial Rd
Suite 100
Virginia Beach, VA 23454-2418
Phone
(757) 481-2333
NPI assigned
Jan 7, 2010
Last updated
Jan 7, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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 0110003205 VA Primary

Addresses

Primary practice location

1120 First Colonial Rd
Suite 100
Virginia Beach, VA 23454-2418

Mailing address

1120 First Colonial Rd
Suite 100
Virginia Beach, VA 23454-2418
Phone (757) 481-2333

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
I20160928000712 VA Practitioner - Physician Assistant 2365661881 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Aug 19, 2016 Accepting new patients
Privia Medical Group, LLC CurrentSince Aug 19, 2016 Accepting new patients

Locations

8644 Sudley Rd
#220
Manassas, VA 20110

1120 First Colonial Rd
Ste 100
Virginia Beach, VA 23454
Phone (757) 481-2333

Organizations & group practices 2

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": "1262822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262822400000",
    "number": "1326378746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 FIRST COLONIAL RD",
            "address_2": "SUITE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542418",
            "telephone_number": "757-481-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 FIRST COLONIAL RD",
            "address_2": "SUITE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542418",
            "telephone_number": "757-481-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALBON",
        "first_name": "KATHARINE",
        "middle_name": "K",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-07",
        "last_updated": "2010-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110003205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.