Active NPI
Holly Jason Kibble, M.D.
- General Practice Physician
- Richmond, VA
National Provider Identifier
1447478219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 0101238400
- Practice address
- 1300 W Broad St
Suite 2200
Richmond, VA 23284-9089 - Phone
- (804) 828-7320
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 0101238400 | VA | Primary |
Addresses
Primary practice location
1300 W Broad St
Suite 2200
Richmond, VA 23284-9089
Mailing address
4626 Halleys Cir
Glen Allen, VA 23060-3551
Phone (804) 217-8043
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101238400 | VA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447478219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4626 HALLEYS CIR",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230603551",
"telephone_number": "804-217-8043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 W BROAD ST",
"address_2": "SUITE 2200",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232849089",
"telephone_number": "804-828-7320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIBBLE",
"first_name": "HOLLY",
"middle_name": "JASON",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "VA",
"license": "0101238400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.