Katie Marie Jagmin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110-008804 Issued in VA

Practice address

95 Dunn Dr Ste 123
Stafford, VA 22556-1503

Phone

(703) 523-9570

NPI assigned

Feb 21, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270

  VA

  Medicare reassignment Care Compare group NPD
• Sentara Medical Group

  • Diagnostic Radiology Physician
  • Virginia Beach, VA
  • NPI 1053350322
  Care Compare group
• Sentara Medical Group

  • Diagnostic Radiology Physician
  • Chesapeake, VA
  • NPI 1487195111
  Care Compare group
• Family Medcare, LLC

  • Health Service Clinic/Center
  • Bryans Road, MD
  • NPI 1346421039
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Potomac Hospital Corporation of Prince William

  • General Acute Care Hospital
  • Woodbridge, VA
  • NPI 1548366404

  Hospital

  Care Compare affiliation
• Sentara Enterprises

  • Home Health Agency
  • Dumfries, VA
  • NPI 1831414192
  Care Compare affiliation

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sentara Medical Group 1,396 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Home Care Services Home health agency, Dumfries, VA, CCN 497675
• Sentara Northern Virginia Medical Center Hospital, Woodbridge, VA, CCN 490113

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1629601224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 DUNN DR STE 123",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225561503",
            "telephone_number": "703-523-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 DUNN DR STE 123",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225561503",
            "telephone_number": "703-523-9570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3068 Route 9W Ste 200",
            "address_purpose": "LOCATION",
            "city": "New Windsor",
            "state": "NY",
            "postal_code": "125537663",
            "country_code": "US",
            "telephone_number": "845-534-1505",
            "fax_number": "845-563-0110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "85 High St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206022150",
            "country_code": "US",
            "telephone_number": "301-375-8080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAGMIN",
        "first_name": "KATIE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-21",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027201",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0008632",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-008804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anteyauna Jackson
• Jonee Jackson
• Teyona C Jackson
• Tricia Jeneen Jackson, MSCJ, MSW, LCSW
• Heather Renee Cox Jacobs, M.S., CCC-SLP
• Hawah Nenneh Jalloh
• Abigail Daria James
• Katherine Jefferson, CCC-SLP
• Jenise M. Mancini O.D., P.C.
• Kaylin Renee Jennings-Knight

• All providers in Stafford, VA
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.

Verify at the official NPI Registry.