Organization Active NPI

Kevin C Harrison, DO PC

  • Internal Medicine Physician
  • Richmond, VA
National Provider Identifier
1396926143
Registry record updated Oct 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0102201098 Issued in VA
Legal business name
KEVIN C HARRISON, DO PC
Practice address
9460 Amberdale Drive
Suite C
Richmond, VA 23236
Phone
(804) 276-2470
Fax
(804) 276-2473
NPI assigned
Nov 21, 2007
Last updated
Oct 26, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2009

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

Authorized official

Name
Dr. Kevin Charles Harrison, D.O.NPI 1073514238
Title
Physician/President
Phone
(804) 276-2470

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0102-032395 VA
Internal Medicine Physician 207R00000X 0102-201098 VA
Internal Medicine Physician 207R00000X 0102201098 VA Primary

Addresses

Primary practice location

9460 Amberdale Drive
Suite C
Richmond, VA 23236

Mailing address

9460 Amberdale Drive
Suite C
Richmond, VA 23236
Phone (804) 276-2470

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040818001408 VA Part B Supplier - Clinic/Group Practice 0547233314 Receives reassigned benefits from 1 practitioner
Practice locations: North Chesterfield, VA

National Provider Directory

National Provider Directory

Locations

9460 Amberdale Dr
Ste C
North Chesterfield, VA 23236
Phone (804) 276-2470

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256515200000",
    "number": "1396926143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9460 AMBERDALE DRIVE",
            "address_2": "SUITE C",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23236",
            "telephone_number": "804-276-2470",
            "fax_number": "804-276-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9460 AMBERDALE DRIVE",
            "address_2": "SUITE C",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23236",
            "telephone_number": "804-276-2470",
            "fax_number": "804-276-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN C HARRISON, DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-21",
        "last_updated": "2009-10-26",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "804-276-2470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102-032395",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102-201098",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102201098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.