Active NPI
Mary Kathryn Huddleston, M.D.
- Vascular Surgery Physician
- Hampton, VA
National Provider Identifier
1629337324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 0101269608
- Practice address
- 3000 Coliseum Dr Ste 200
Hampton, VA 23666-5963 - Phone
- (757) 736-7250
- Fax
- (757) 224-2198
- NPI assigned
- May 15, 2012
- Last updated
- Jan 17, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Vascular Surgery Physician | 2086S0129X | 0101269608 | VA | Primary |
Addresses
Primary practice location
3000 Coliseum Dr Ste 200
Hampton, VA 23666-5963
Mailing address
3000 Coliseum Dr Ste 200
Hampton, VA 23666-5963
Phone (757) 736-7250
Other names 1
- Dr. Marykathryn Huddleston Colburn
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- University of Alabama School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3000 Coliseum Dr
Hampton, VA 23666-5963
Phone (757) 736-7250
Hospital & facility affiliations
- Sentara Careplex Hospital
- Sentara Williamsburg Regional Medical Center
- Sentara Norfolk General Hospital
- Sentara Obici Hospital
- Mary Immaculate Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 26 |
| Leg revascularization (restoring blood flow) | 1-10 |
| Removal of tissue | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101269608 | VA | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sentara Medical Group | Vascular Surgery | Current | Accepting new patients |
Locations
3000 Coliseum Dr
Ste 200
Hampton, VA 23666
Phone (757) 736-7250
850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162
Interoperability endpoints
- mhuddleston630239@direct.sentara.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Newport News, VA
- NPI 1427064310
-
dba Sentara Careplex Hospital
- General Acute Care Hospital
- Hampton, VA
- NPI 1336109107
-
dba Sentara Norfolk General Hospital
- General Acute Care Hospital
- Norfolk, VA
- NPI 1437119310
-
dba Sentara Williamsburg Regional Medical Center
- General Acute Care Hospital
- Williamsburg, VA
- NPI 1619938149
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705449600000",
"number": "1629337324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 COLISEUM DR STE 200",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236665963",
"telephone_number": "757-736-7250",
"fax_number": "757-224-2198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 COLISEUM DR STE 200",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236665963",
"telephone_number": "757-736-7250",
"fax_number": "757-224-2198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDDLESTON",
"first_name": "MARY KATHRYN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-15",
"last_updated": "2024-01-17",
"certification_date": "2024-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "VA",
"license": "0101269608",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARYKATHRYN",
"last_name": "COLBURN",
"middle_name": "HUDDLESTON",
"prefix": "DR.",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Hampton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.