NPIMap

Individual provider Active NPI

Kimberly Anne Quinter, PA-C

  • Physician Assistant
  • Suffolk, VA
National Provider Identifier
1518290378
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110003090 Issued in VA
Practice address
2760 Godwin Blvd Ste 100
Suffolk, VA 23434-8501
Phone
(757) 983-8650
Fax
(757) 983-8673
NPI assigned
Sep 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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 0110003090 VA Primary

Addresses

Primary practice location

2760 Godwin Blvd Ste 100
Suffolk, VA 23434-8501

Mailing address

16160 Quail Crescent LN
Carrollton, VA 23314-2251
Phone (757) 802-2033

Other practice location 1

16160 Quail Crescent Ln
Carrollton, VA 23314-2251
Phone (757) 802-2033

Other identifiers 2

IdentifierTypeStateIssuer
1518290378MedicaidVA
021253J36OtherVAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091009000219 VA Practitioner - Physician Assistant 6709922453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
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)

2760 Godwin Blvd
Suite 100
Suffolk, VA 23434-8501
Phone (757) 983-8650

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Mar 22, 2021 Accepting new patients

Locations

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

2760 Godwin Blvd
Ste 100
Suffolk, VA 23434
Phone (757) 983-8650

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 7

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": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1518290378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16160 QUAIL CRESCENT LN",
            "city": "CARROLLTON",
            "state": "VA",
            "postal_code": "233142251",
            "telephone_number": "757-802-2033",
            "fax_number": "757-838-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2760 GODWIN BLVD STE 100",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348501",
            "telephone_number": "757-983-8650",
            "fax_number": "757-983-8673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16160 Quail Crescent Ln",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "VA",
            "postal_code": "233142251",
            "country_code": "US",
            "telephone_number": "757-802-2033",
            "fax_number": "757-838-2034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINTER",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-11",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518290378",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "021253J36",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.