Individual provider Active NPI

Kendra Robinson, MSN, FNP-BC, CDE

  • Family Nurse Practitioner
  • Williamsburg, VA
National Provider Identifier
1497132880
Registry record updated Oct 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024175532 Issued in VA
Practice address
5249 Olde Towne Rd
Williamsburg, VA 23188-8111
Phone
(757) 259-3258
Fax
(757) 220-1953
NPI assigned
May 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 0001199696 VA
Family Nurse Practitioner 363LF0000X 0024175532 VA Primary

Addresses

Primary practice location

5249 Olde Towne Rd
Williamsburg, VA 23188-8111

Mailing address

5249 Olde Towne Rd
Williamsburg, VA 23188-8111
Phone (757) 259-3258

Other identifiers 3

IdentifierTypeStateIssuer
21210487OtherVACDE
0024175532OtherVABOARD OF NURSING
0017144465OtherVABOARD OF NURSING

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
I20171201000136 VA Order and Referring Only - Nurse Practitioner 7315204211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0001199696VAMDDiabetes Educator Registered Nurse
0024175532VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Williamsburg Area Medical Assistance Corporation Past Accepting new patients
Williamsburg Area Medical Assistance Corporation Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1497132880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5249 OLDE TOWNE RD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231888111",
            "telephone_number": "757-259-3258",
            "fax_number": "757-220-1953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5249 OLDE TOWNE RD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231888111",
            "telephone_number": "757-259-3258",
            "fax_number": "757-220-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "KENDRA",
        "credential": "MSN, FNP-BC, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-05",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "VA",
            "license": "0001199696",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024175532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDE",
            "identifier": "21210487",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING",
            "identifier": "0024175532",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING",
            "identifier": "0017144465",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.