Individual provider Active NPI

Anne Kennedy, NP

  • Family Nurse Practitioner
  • Newport News, VA
National Provider Identifier
1336749209
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024179390 Issued in VI
Practice address
101 Philip Roth St
Newport News, VA 23606-1393
Phone
(757) 599-6333
NPI assigned
Oct 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024179390 VI Primary

Addresses

Primary practice location

101 Philip Roth St
Newport News, VA 23606-1393

Mailing address

856 J Clyde Morris Blvd Ste a
Newport News, VA 23601-1318
Phone (757) 316-5800

Other practice location 1

500 J Clyde Morris Blvd
Newport News, VA 23601-1929
Phone (757) 594-2000

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
I20201202001113 VA Practitioner - Nurse Practitioner 1254742968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

101 Philip Roth St
Suite 5 a
Newport News, VA 23606-1393
Phone (757) 599-6333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.91 of 100Reported as apm
Quality
92.86
Promoting interoperability
94.93
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024179390VIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc CurrentSince Dec 7, 2020 Accepting new patients
Riverside Physician Services, Inc. CurrentSince Dec 7, 2020 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services Inc Past Accepting new patients

Locations

850 Enterprise Pkwy
Hampton, VA 23666
Phone (757) 594-2796

850 Enterprise Pkwy
Ste 2000
Hampton, VA 23666
Phone (757) 534-6109

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

101 Philip Roth St
Ste 5A
Newport News, VA 23606
Phone (757) 599-6333

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

101 Philip Roth St
Newport News, VA 23606
Phone (757) 599-6333

500 J Clyde Morris Blvd
North North, VA 23601
Phone (757) 594-2000

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1336749209",
    "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": "101 PHILIP ROTH ST",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236061393",
            "telephone_number": "757-599-6333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 J Clyde Morris Blvd",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236011929",
            "country_code": "US",
            "telephone_number": "757-594-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VI",
            "license": "0024179390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.