Audrey Elizabeth Keen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-005839 Issued in VA

Practice address

5510 Alma LN
Springfield, VA 22151-4027

Phone

(703) 642-5990

NPI assigned

Jan 13, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

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 1

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Virginia Medical Alliance, P.C.Group PAC ID 0648262261, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Virginia Medical Alliance PC

  • Internal Medicine Physician
  • Springfield, VA
  • NPI 1225083223

  DC

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1417252974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5843 NEW ENGLAND WOODS DR",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220152963",
            "telephone_number": "571-317-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 ALMA LN",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221514027",
            "telephone_number": "703-642-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEN",
        "first_name": "AUDREY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-13",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0010-005839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamanna Kazi
• KCB Play Institute Inc
• Abigail Kearney
• Matthew John Keast, D.P.M.
• Rebecca Sevillano Keegan
• Stephanie Keenan, CCC-SLP
• Keg Ventures Inc. (Seniors Helping Seniors)
• Melanie Kellett
• Jeremiah Joseph Kelliher Jr., DDS
• Sean Patrick Kelliher, DDS

• Physician Assistant in Springfield, VA
• Providers in Springfield, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.