Brenden Kootsey, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101264322 Issued in VA

Practice address

86 Harris Rd
Kilmarnock, VA 22482

Phone

(804) 435-1152

Fax

(804) 434-8080

NPI assigned

Apr 19, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Johnson Health Center

  • Federally Qualified Health Center (FQHC)
  • Lynchburg, VA
  • NPI 1821212481

  Pediatrics

  Medicare reassignment NPD
• Johnson Health Center

  • Federally Qualified Health Center (FQHC)
  • Madison Heights, VA
  • NPI 1972858660
  NPD

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1487911095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 HARRIS RD",
            "city": "KILMARNOCK",
            "state": "VA",
            "postal_code": "224823845",
            "telephone_number": "804-435-1152",
            "fax_number": "804-435-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 HARRIS RD",
            "city": "KILMARNOCK",
            "state": "VA",
            "postal_code": "22482",
            "telephone_number": "804-435-1152",
            "fax_number": "804-434-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOTSEY",
        "first_name": "BRENDEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-19",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "52671",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101264322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kilmarnock Orthopaedics, Inc.
• Kilmarnock Pharmacy Inc
• Kilmarnock Pharmacy Inc
• Vicki A Kinsel, MD
• Deanna M Kiple, R.PH.
• Lancashire Operator LLC
• Lanigan Family Dentistry PLLC
• Jacqueline Culver Lanigan, D.M.D.
• Peter Andrew Lanigan Jr., DDS
• Andrea Latell

• Pediatrics Physician in Kilmarnock, VA
• Providers in Kilmarnock, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.