Poonam KC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024177565 Issued in VA

Practice address

500 J Clyde Morris Blvd Ste 500
Newport News, VA 23601-1929

Phone

(757) 873-1317

Fax

(757) 873-1612

NPI assigned

Sep 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: pkc10379@direct.rivhs.com

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1326699802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD STE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318",
            "telephone_number": "757-316-5800",
            "fax_number": "757-534-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 J CLYDE MORRIS BLVD STE 500",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011929",
            "telephone_number": "757-873-1317",
            "fax_number": "757-873-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KC",
        "first_name": "POONAM",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024177565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Alexander Kaye, LCSW
• Shaghayegh Kaymanesh, D.D.S.
• Victoria Kayode
• Kian Monica Kaz, MD
• Abhinab KC, MD
• KCS Pulmonary PC
• Robert Christopher Kearn, ATC
• Amy Young Kearney, O.D.
• Tylesha Kebe
• Raven Kee

• Family Nurse Practitioner in Newport News, VA
• Providers in Newport News, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.