Individual provider Active NPI

Jody P. King, MD

  • Internal Medicine Physician
  • Norfolk, VA
National Provider Identifier
1407019458
Registry record updated Jul 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101249342 Issued in VA
Practice address
825 Fairfax Ave Ste 445
Norfolk, VA 23507-1914
Phone
(757) 446-8920
Fax
(757) 446-5242
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101249342 VA Primary

Addresses

Primary practice location

825 Fairfax Ave Ste 445
Norfolk, VA 23507-1914

Mailing address

PO Box 936
Norfolk, VA 23501-0936
Phone (757) 446-8920

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110615000505 VA Practitioner - Internal Medicine 3779760905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Eastern Virginia Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

825 Fairfax Ave
Norfolk, VA 23507-1914
Phone (757) 446-8920

Hospital & facility affiliations

  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044
  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101249342VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evms Academic Physicians and Surgeons Health Services Foundation Internal Medicine CurrentSince Jul 1, 2011 Accepting new patients

Locations

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

825 Fairfax Ave
Ste 445
Norfolk, VA 23507
Phone (757) 446-5758

Organizations & group practices 1

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 6

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": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562284800000",
    "number": "1407019458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235010936",
            "telephone_number": "757-446-8920",
            "fax_number": "757-446-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE STE 445",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-8920",
            "fax_number": "757-446-5242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JODY",
        "middle_name": "P.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2019-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101249342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.