Individual provider Active NPI

Jeffrey L Kent, DO

  • Family Medicine Physician
  • Potomac Falls, VA
National Provider Identifier
1538276068
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102206533 Issued in VA
Doing business as
Jeffrey Laurence Kent
Practice address
46045 Palisade Pkwy
Potomac Falls, VA 20165-8761
Phone
(703) 430-4343
Fax
(571) 313-8865
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 46446 WI
Family Medicine Physician 207Q00000X 5101012007 MI
Family Medicine Physician 207Q00000X 0102206533 VA Primary

Addresses

Primary practice location

46045 Palisade Pkwy
Potomac Falls, VA 20165-8761

Mailing address

PO Box 37189
Baltimore, MD 21297-3189
Phone (571) 423-5699

Other practice location 1

420 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 926-8200

Other names 1

  • Jeffrey Laurence Kent Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jkent331009@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211020001285 VA Practitioner - Family Practice 4486555034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.98 of 100Reported as apm
Quality
87.97
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102206533VAMDFamily Medicine Physician
46446WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Physician Partners, LLC Family Medicine CurrentSince Sep 13, 2021 Accepting new patients
Botsford General Hospital Past Accepting new patients
Inova Physician Partners, Inc. - Specialists PastSince Oct 31, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

46045 Palisade Pkwy
Potomac Falls, VA 20165
Phone (703) 430-4343

740 E Main St
Purcellville, VA 20132
Phone (540) 338-4995

Interoperability endpoints

  • Direct secure messaging: jkent331009@direct-ehr-ssmhc.com

Organizations & group practices 4

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1538276068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37189",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973189",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46045 PALISADE PKWY",
            "city": "POTOMAC FALLS",
            "state": "VA",
            "postal_code": "201658761",
            "telephone_number": "703-430-4343",
            "fax_number": "571-313-8865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 E Division St",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549354560",
            "country_code": "US",
            "telephone_number": "920-926-8200",
            "fax_number": "920-926-8907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENT",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "46446",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101012007",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102206533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkent331009@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jkent331009@direct-ehr-ssmhc.com",
            "address_1": "420 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "420 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JEFFREY",
            "last_name": "KENT",
            "middle_name": "LAURENCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Potomac Falls, VA

Sources for this page

Verify at the official NPI Registry.