NPIMap

Organization Active NPI

Kidmed Inc.

  • Urgent Care Clinic/Center
  • Glen Allen, VA
National Provider Identifier
1407013121
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
KIDMED INC.
Practice address
4687 Pouncey Tract Rd
Glen Allen, VA 23059-5802
Phone
(804) 647-2240
NPI assigned
May 20, 2008
Organization subpart
Yes
Parent organization
KIDMED INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Authorized official

Name
Dr. Mark A Flanzenbaum, MDNPI 1134129398
Title
President
Phone
(804) 592-5437

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
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

4687 Pouncey Tract Rd
Glen Allen, VA 23059-5802

Mailing address

4687 Pouncey Tract Rd
Glen Allen, VA 23059-5802
Phone (804) 422-5437

Other names 1

  • KidMed West End Doing business as

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
49D1087292Kidmed West End4687 Pouncey Tract Road, Glen Allen, VA 23059ComplianceAug 26, 2027

National Provider Directory

National Provider Directory
Part of
Kidmed Inc

Locations

4687 Pouncey Tract Rd
Glen Allen, VA 23059
Phone (804) 422-5437

8356 Bell Creek Rd
Mechanicsville, VA 23116
Phone (804) 559-5437

5021 Craig Rath Blvd
Midlothian, VA 23112
Phone (804) 517-1653

Interoperability endpoints

  • Direct secure messaging: janaeowens@kidmed.allscriptsdirect.net
  • Direct secure messaging: viviennelarose@kidmed.allscriptsdirect.net
  • Direct secure messaging: melaniereed@kidmed.allscriptsdirect.net
  • Direct secure messaging: leighannbreckenridge@kidmed.allscriptsdirect.net
  • Direct secure messaging: rileighecker@kidmed.allscriptsdirect.net
  • Direct secure messaging: ashleyapple@kidmed.allscriptsdirect.net
  • Direct secure messaging: sarahhoran@kidmed.allscriptsdirect.net
  • Direct secure messaging: arinlee@kidmed.allscriptsdirect.net
  • Direct secure messaging: jeffreybennett@kidmed.allscriptsdirect.net
  • Direct secure messaging: carolineleslie@kidmed.allscriptsdirect.net
  • Direct secure messaging: akelahglenn@kidmed.allscriptsdirect.net
  • Direct secure messaging: ellikarasooly@kidmed.allscriptsdirect.net
  • Direct secure messaging: saadiyajacksonowens@kidmed.allscriptsdirect.net
  • Direct secure messaging: kevinkissner@kidmed.allscriptsdirect.net
  • Direct secure messaging: lindsayewan@kidmed.allscriptsdirect.net
  • Direct secure messaging: lauraduke@kidmed.allscriptsdirect.net
  • Direct secure messaging: rachelbailey@kidmed.allscriptsdirect.net
  • Direct secure messaging: jessicawester@kidmed.allscriptsdirect.net
  • Direct secure messaging: aishavenugopal@kidmed.allscriptsdirect.net
  • Direct secure messaging: annamueller@kidmed.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 56

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1407013121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4687 POUNCEY TRACT RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595802",
            "telephone_number": "804-422-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4687 POUNCEY TRACT RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595802",
            "telephone_number": "804-647-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDMED INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KIDMED INC.",
        "enumeration_date": "2008-05-20",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "FLANZENBAUM",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-592-5437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KidMed West End",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.