Individual provider Active NPI

Katie Elizabeth Sharrock, PA-C

  • Medical Physician Assistant
  • Norfolk, VA
National Provider Identifier
1386931467
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1097948 Issued in VA
Practice address
110 Kingsley Lane
Suite 305
Norfolk, VA 23505-4617
Phone
(757) 889-5942
Fax
(757) 889-5450
NPI assigned
Jul 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1097948 VA Primary

Addresses

Primary practice location

110 Kingsley Lane
Suite 305
Norfolk, VA 23505-4617

Mailing address

PO Box 844555
Boston, MA 02284-4555
Phone (540) 891-8730

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
I20120918000127 VA Practitioner - Physician Assistant 6002064029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hampton Roads Radiology Associates, PCGroup PAC ID 4880688506, 39 clinicians

Practice addresses (Care Compare)

1060 1St Colonial Rd
Virginia BCH, VA 23454-3002
Phone (757) 395-8000

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178
Phone (757) 916-9630

582 Lynnhaven Pkwy
Suite 301
Virginia Beach, VA 23452-7386
Phone (757) 916-9630

Hospital & facility affiliations

  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057

Merit-based Incentive Payment System (MIPS)

Final score
93.4 of 100Reported as group
Quality
100
Improvement activities
40
Cost
77.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1097948VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kingsley Lane Anatomic Pathology Current 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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1386931467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844555",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022844555",
            "telephone_number": "540-891-8730",
            "fax_number": "540-891-5742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 KINGSLEY LANE",
            "address_2": "SUITE 305",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054617",
            "telephone_number": "757-889-5942",
            "fax_number": "757-889-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARROCK",
        "first_name": "KATIE",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "1097948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.