Individual provider Active NPI

Keyannah Patel

  • Nurse Practitioner
  • Fredericksburg, VA
National Provider Identifier
1407661499
Registry record updated Feb 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024191162 Issued in VA
Practice address
406 Chatham Square Office Park
Fredericksburg, VA 22405-2585
Phone
(540) 666-6181
NPI assigned
Feb 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024191162 VA Primary

Addresses

Primary practice location

406 Chatham Square Office Park
Fredericksburg, VA 22405-2585

Mailing address

185 River Acres LN
Fredericksburg, VA 22406-5430
Phone (540) 845-7203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 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
I20250407003815 VA Practitioner - Nurse Practitioner 9537683941 Reassigns benefits to 1 organization
I20250416000710 DC Practitioner - Nurse Practitioner 9537683941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Cardiac and Vascular LLCGroup PAC ID 2365777547, 4 clinicians

Practice addresses (Care Compare)

406 Chatham Square Office Park
Fredericksburg, VA 22405-2585
Phone (540) 666-6181

5105 I Backlick Rd
Annandale, VA 22003-6065
Phone (540) 645-5508

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024191162VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Cardiac and Vascular LLC CurrentSince Feb 21, 2025 Accepting new patients

Locations

5105J Backlick Rd
Annandale, VA 22003
Phone (540) 645-5508

406 Chatham Square Office Park
Fredericksburg, VA 22405
Phone (540) 300-6182

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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 4

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": "1738972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738972800000",
    "number": "1407661499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 RIVER ACRES LN",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224065430",
            "telephone_number": "540-845-7203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 CHATHAM SQUARE OFFICE PARK",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224052585",
            "telephone_number": "540-666-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KEYANNAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-08",
        "last_updated": "2025-02-08",
        "certification_date": "2025-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024191162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.