Individual provider Active NPI

Kara Marie Cavanaugh, PA-C

  • Physician Assistant
  • Virginia Beach, VA
National Provider Identifier
1477209757
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110010942 Issued in VA
Practice address
1950 Glenn Mitchell Dr Ste 300
Virginia Beach, VA 23456-0048
Phone
(757) 507-0305
NPI assigned
Feb 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110010942 VA Primary

Addresses

Primary practice location

1950 Glenn Mitchell Dr Ste 300
Virginia Beach, VA 23456-0048

Mailing address

200 College PL Apt 317
Norfolk, VA 23510-0904

Other practice location 1

911 E 9 Mile Rd
Ferndale, MI 48220-1934
Phone (248) 336-4000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250925004545 VA Practitioner - Physician Assistant 4385039254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

1950 Glenn Mitchell Dr
Suite 300
Virginia Beach, VA 23456-0048
Phone (757) 507-0305

830 Kempsville Rd
2B223
Norfolk, VA 23502-3920
Phone (757) 261-8860

850 Kempsville Rd
Norfolk, VA 23502-3920

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110010942VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Oct 1, 2025 Accepting new patients

Locations

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

1950 Glenn Mitchell Dr
Ste 300
Virginia Beach, VA 23456
Phone (757) 507-0305

Interoperability endpoints

  • Direct secure messaging: kcavanaugh1083996@direct.sentara.net
  • Direct secure messaging: kwertz782194@direct.hfhs.org

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 3

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": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1477209757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 COLLEGE PL APT 317",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235100904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 GLENN MITCHELL DR STE 300",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560048",
            "telephone_number": "757-507-0305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "911 E 9 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Ferndale",
            "state": "MI",
            "postal_code": "482201934",
            "country_code": "US",
            "telephone_number": "248-336-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "KARA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-25",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.