Active NPI
Kevin Michael Wemyss, PA-C
- Physician Assistant
- Fort Lee, VA
National Provider Identifier
1336138866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110005570
- Practice address
- 700 24TH St
Fort Lee, VA 23801-1716 - Phone
- (804) 734-9226
- Fax
- (804) 734-9562
- NPI assigned
- Oct 18, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1066163 | ||
| Physician Assistant | 363A00000X | 0110005570 | VA | Primary |
Addresses
Primary practice location
700 24TH St
Fort Lee, VA 23801-1716
Mailing address
700 24TH St
Fort Lee, VA 23801-1716
Phone (804) 734-9226
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000335800 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110005570 | VA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rainier Emergency Physicians LLC | Physician Assistant | Past | Accepting new patients |
| Redner Emergency Physicians, LLC | Past | Accepting new patients |
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.
-
- Emergency Medicine Physician
- Plant City, FL
- NPI 1508275447
Physician Assistant
-
- Emergency Medicine Physician
- Plant City, FL
- NPI 1295083483
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685923200000",
"number": "1336138866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 24TH ST",
"city": "FORT LEE",
"state": "VA",
"postal_code": "238011716",
"telephone_number": "804-734-9226",
"fax_number": "804-734-9562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 24TH ST",
"city": "FORT LEE",
"state": "VA",
"postal_code": "238011716",
"telephone_number": "804-734-9226",
"fax_number": "804-734-9562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEMYSS",
"first_name": "KEVIN",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-18",
"last_updated": "2023-06-05",
"certification_date": "2023-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": "1066163",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110005570",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000335800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Lee, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.