NPIMap

Individual provider Active NPI

Kensley Nichols, M.D.

  • Infectious Disease Physician
  • Lynchburg, VA
National Provider Identifier
1407054745
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
0101261116 Issued in VA
Practice address
2215 Landover PL
Lynchburg, VA 24501-2115
Phone
(434) 947-3944
Fax
(434) 544-2337
NPI assigned
Jul 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 048960 CT
Infectious Disease Physician 207RI0200X 48960 CT
Infectious Disease Physician 207RI0200X 0101261116 VA Primary

Addresses

Primary practice location

2215 Landover PL
Lynchburg, VA 24501-2115

Mailing address

2215 Landover PL
Lynchburg, VA 24501-2115
Phone (434) 947-3944

Other identifiers 2

IdentifierTypeStateIssuer
048960OtherCTCT LICENSE
1407054745MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161103000973 VA Practitioner - Infectious DiseasePractitioner - Internal Medicine 9032301908 Reassigns benefits to 3 organizations
I20260604000845 MI Practitioner - Infectious Disease 9032301908

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Infectious Disease Associates of Central Virginia LLCGroup PAC ID 5496007643, 6 clinicians

Practice addresses (Care Compare)

2215 Landover PL
Lynchburg, VA 24501-2115
Phone (434) 947-3900

Hospital & facility affiliations

  • Centra Health - Lynchburg Gen Hospital Hospital, Lynchburg, VA, CCN 490021
  • Centra Bedford Memorial Hospital Hospital, Bedford, VA, CCN 490088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48960CTMDInfectious Disease Physician
0101261116VAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intravene LLC Infectious Disease CurrentSince Oct 1, 2016 Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 3, 2016 Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 3, 2016 Accepting new patients
Infectious Disease Associates of Central Virginia, LLC Infectious Disease CurrentSince Sep 1, 2018 Accepting new patients

Locations

1415 Rolkin Ct
Ste 201
Charlottesville, VA 22911
Phone (434) 202-8064

4545 Riverside Dr
Ste D
Danville, VA 24541
Phone (434) 792-0493

4500 Riverside Dr
#B
Danville, VA 24541
Phone (434) 710-4305

2215 Landover Pl
Lynchburg, VA 24501
Phone (434) 947-3900

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

8644 Sudley Rd
#220
Manassas, VA 20110

Interoperability endpoints

  • Direct secure messaging: kensley.nichols.1@18196.direct.athenahealth.com

Organizations & group practices 4

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 8

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": "1183939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1407054745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 LANDOVER PL",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012115",
            "telephone_number": "434-947-3944",
            "fax_number": "434-544-2337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 LANDOVER PL",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012115",
            "telephone_number": "434-947-3944",
            "fax_number": "434-544-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "KENSLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-09",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "048960",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CT",
            "license": "48960",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "VA",
            "license": "0101261116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT LICENSE",
            "identifier": "048960",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407054745",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.