NPIMap

Organization Active NPI

Colonial Internal Medicine Associates PC

  • Internal Medicine Physician
  • Fredericksburg, VA
National Provider Identifier
1346260940
Registry record updated Feb 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0102201579 Issued in VA
Legal business name
COLONIAL INTERNAL MEDICINE ASSOCIATES PC
Practice address
125 Olde Greenwich Dr
Suite 300
Fredericksburg, VA 22408-4001
Phone
(540) 374-5599
Fax
(540) 735-8097
NPI assigned
Jul 20, 2006
Last updated
Feb 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2008

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

Authorized official

Name
Kenneth M McDowell, MDNPI 1306834379
Title
Physician Owner
Phone
(540) 374-5599

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0102201579 VA Primary

Addresses

Primary practice location

125 Olde Greenwich Dr
Suite 300
Fredericksburg, VA 22408-4001

Mailing address

125 Olde Greenwich Dr
Suite 300
Fredericksburg, VA 22408-4001
Phone (540) 374-5599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040902000556 VA Part B Supplier - Clinic/Group Practice 6608842521 Receives reassigned benefits from 32 practitioners
Practice locations: Stafford, VA; Fredericksburg, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D1031098Colonial Internal Medicine Associates125 Olde Greenwich Drive - Suite 300, Fredericksbrg, VA 22408Certificate of waiverSep 22, 2026

National Provider Directory

National Provider Directory

Locations

121 Park Hill Dr
#B
Fredericksburg, VA 22401
Phone (540) 374-5599

125 Olde Greenwich Dr
Ste 300
Fredericksburg, VA 22408
Phone (540) 374-5599

392 Garrisonville Rd
Ste 106
Stafford, VA 22554
Phone (540) 374-5599

394 Garrisonville Rd
Ste 103
Stafford, VA 22554
Phone (540) 374-5599

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202947200000",
    "number": "1346260940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 OLDE GREENWICH DR",
            "address_2": "SUITE 300",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224084001",
            "telephone_number": "540-374-5599",
            "fax_number": "540-735-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 OLDE GREENWICH DR",
            "address_2": "SUITE 300",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224084001",
            "telephone_number": "540-374-5599",
            "fax_number": "540-735-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL INTERNAL MEDICINE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-02-14",
        "status": "A",
        "authorized_official_last_name": "MCDOWELL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "540-374-5599",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102201579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.