Individual provider Active NPI

Kristyn Dolores Fox

  • Gerontology Nurse Practitioner
  • Norfolk, VA
National Provider Identifier
1326670100
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0024178819 Issued in VA
Practice address
830 Kempsville Rd Ste 2B223
Norfolk, VA 23502-3920
Phone
(757) 261-8860
Fax
(757) 689-2420
NPI assigned
Feb 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 0024178819 VA Primary

Addresses

Primary practice location

830 Kempsville Rd Ste 2B223
Norfolk, VA 23502-3920

Mailing address

1540 Longparish Way
Chesapeake, VA 23320-2978

Other practice location 1

1540 Longparish Way
Chesapeake, VA 23320-2978
Phone (757) 375-2424

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
I20200921000722 VA Practitioner - Nurse Practitioner 4880012038 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024178819VAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Oct 26, 2020 Accepting new patients
Sentara Medical Group PastSince Oct 26, 2020 Accepting new patients

Locations

830 Kempsville Rd
Ste 2B223
Norfolk, VA 23502
Phone (757) 261-8860

830 Kempsville Rd
Rm 2B223
Norfolk, VA 23502
Phone (757) 261-8860

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

830 Kempsville Rd
#2B223
Norfolk, VA 23502
Phone (757) 261-8860

Interoperability endpoints

  • Direct secure messaging: kristyn.fox.1@24900.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1326670100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 LONGPARISH WAY",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 KEMPSVILLE RD STE 2B223",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023920",
            "telephone_number": "757-261-8860",
            "fax_number": "757-689-2420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1540 Longparish Way",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233202978",
            "country_code": "US",
            "telephone_number": "757-375-2424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOX",
        "first_name": "KRISTYN",
        "middle_name": "DOLORES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024178819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.