Individual provider Active NPI

Patricia Anne Kearney, MD

  • Pediatrics Physician
  • Dumfries, VA
National Provider Identifier
1619079308
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
K6039 Issued in TX
Practice address
3700 Fettler Park
Dumfries Health Center
Dumfries, VA 22025
Phone
(703) 441-7500
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X K6039 TX Primary

Addresses

Primary practice location

3700 Fettler Park
Dumfries Health Center
Dumfries, VA 22025

Mailing address

3700 Fettler Park
Dumfries Health Center
Dumfries, VA 22025
Phone (703) 441-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20170614002063 DC Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4688727050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K6039TXMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1619079308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 FETTLER PARK",
            "address_2": "DUMFRIES HEALTH CENTER",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "22025",
            "telephone_number": "703-441-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 FETTLER PARK",
            "address_2": "DUMFRIES HEALTH CENTER",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "22025",
            "telephone_number": "703-441-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARNEY",
        "first_name": "PATRICIA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K6039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dumfries, VA

Sources for this page

Verify at the official NPI Registry.