Individual provider Active NPI

Candice R Keen, PA

  • Cardiovascular Disease Physician
  • Norfolk, VA
National Provider Identifier
1578719506
Registry record updated Oct 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
0110002817 Issued in VA
Practice address
844 Kempsville Rd
Suite 204
Norfolk, VA 23502-3927
Phone
(757) 261-0700
Fax
(757) 962-1254
NPI assigned
Aug 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 0110002817 VA Primary

Addresses

Primary practice location

844 Kempsville Rd
Suite 204
Norfolk, VA 23502-3927

Mailing address

205 Business Park Dr
Suite 200
Virginia Beach, VA 23462-6335
Phone (757) 962-1083

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
I20080920000157 VA Practitioner - Physician Assistant 7810064631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
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)

2075 Glenn Mitchell Dr
Virginia Beach, VA 23456-0179

301 Riverview Ave
Norfolk, VA 23510-1065

600 Gresham Dr
Norfolk, VA 23507-1904

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

844 Kempsville Rd
Norfolk, VA 23502-3927

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 Cardiovascular Disease CurrentSince Jul 1, 2012 Accepting new patients
Cardiology Consultants, LTD Cardiovascular Disease Past Accepting new patients

Locations

301 Riverview Ave
Norfolk, VA 23510
Phone (757) 668-7713

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

301 Riverview Ave
Ste 700
Norfolk, VA 23510
Phone (757) 252-9365

844 Kempsville Rd
Ste 204
Norfolk, VA 23502
Phone (757) 261-0700

1925 Glenn Mitchell Dr
Virginia Beach, VA 23456
Phone (434) 242-5000

Interoperability endpoints

  • Direct secure messaging: ckeen7379@direct.sentara.net

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.

Hospital & facility affiliations 5

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": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225324800000",
    "number": "1578719506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BUSINESS PARK DR",
            "address_2": "SUITE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626335",
            "telephone_number": "757-962-1083",
            "fax_number": "757-962-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 KEMPSVILLE RD",
            "address_2": "SUITE 204",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023927",
            "telephone_number": "757-261-0700",
            "fax_number": "757-962-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEN",
        "first_name": "CANDICE",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-11",
        "last_updated": "2008-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0110002817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.