Individual provider Active NPI

James A Kinder III, PA-C

  • Physician Assistant
  • Waynesboro, VA
National Provider Identifier
1396746939
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002771 Issued in VA
Practice address
201 Lew Dewitt Blvd Ste a
Waynesboro, VA 22980-1663
Phone
(540) 245-7940
Fax
(540) 245-7941
NPI assigned
Aug 4, 2005
Last updated
Sep 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-000242 IL
Physician Assistant 363A00000X 0110002771 VA Primary

Addresses

Primary practice location

201 Lew Dewitt Blvd Ste a
Waynesboro, VA 22980-1663

Mailing address

PO Box 388
Fishersville, VA 22939-0388
Phone (540) 932-5275

Other practice location 1

78 Medical Center Dr
Fishersville, VA 22939-2332
Phone (540) 932-4464

Other identifiers 1

IdentifierTypeStateIssuer
085000242MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090529000083 VA Practitioner - Physician Assistant 6406905173 Reassigns benefits to 1 organization
I20260116000595 WA Practitioner - Physician Assistant 6406905173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians

Practice addresses (Care Compare)

22019 Hwy 99
Suite 120
Edmonds, WA 98026-8002
Phone (864) 664-3984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-000242ILMDPhysician Assistant
0110002771VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Networks on Demand, LLC CurrentSince Nov 8, 2025 Accepting new patients
Peacehealth Networks on Demand, LLC PastSince Aug 1, 2020 Accepting new patients
Zoomcare PC Past Accepting new patients
Peacehealth Networks on Demand, LLC PastSince Aug 1, 2020 Accepting new patients

Locations

10541 NE 4th St
Bellevue, WA 98004
Phone (954) 881-4151

22019 Highway 99
Ste 120
Edmonds, WA 98026

19220 Alderwood Mall Pkwy
Ste 145
Lynnwood, WA 98036

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/30646/brand/1/csg/1/fhir/r4
  • Direct secure messaging: james.kinder.1@14718.direct.athenahealth.com
  • Direct secure messaging: james.kinder.2@30646.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1396746939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229390388",
            "telephone_number": "540-932-5275",
            "fax_number": "540-932-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LEW DEWITT BLVD STE A",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229801663",
            "telephone_number": "540-245-7940",
            "fax_number": "540-245-7941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "78 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Fishersville",
            "state": "VA",
            "postal_code": "229392332",
            "country_code": "US",
            "telephone_number": "540-932-4464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINDER",
        "first_name": "JAMES",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-04",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-000242",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085000242",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, VA

Sources for this page

Verify at the official NPI Registry.