Individual provider Active NPI

Kasheika McNeill, NP

  • Gerontology Nurse Practitioner
  • Woodbridge, VA
National Provider Identifier
1649817016
Registry record updated Oct 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0024183398 Issued in VA
Practice address
1990 Old Bridge Rd Ste 201
Woodbridge, VA 22192-2383
Phone
(703) 492-6822
NPI assigned
Dec 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X 95015949 CA
Primary Care Nurse Practitioner 363LP2300X 11002390 FL
Gerontology Nurse Practitioner 363LG0600X 0024183398 VA Primary

Addresses

Primary practice location

1990 Old Bridge Rd Ste 201
Woodbridge, VA 22192-2383

Mailing address

1990 Old Bridge Rd Ste 201
Woodbridge, VA 22192-2383
Phone (703) 492-6822

Other practice location 1

502 Euclid Ave Ste 200
National City, CA 91950-2984
Phone (619) 434-4019

Other practice location 2

655 W 8th St
Jacksonville, FL 32209-6511
Phone (323) 300-8099

Other practice location 3

1990 Old Bridge Rd Ste 101
Woodbridge, VA 22192-2383
Phone (703) 492-6822

Other practice location 4

422 Garrisonville Rd Ste 104
Stafford, VA 22554-1573
Phone (540) 628-2173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20230613001254 DC Practitioner - Nurse Practitioner 3375900913
I20230615000847 VA Practitioner - Nurse Practitioner 3375900913 Reassigns benefits to 1 organization
I20231011000604 CA Practitioner - Nurse Practitioner 3375900913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
James River Cardiology, LLCGroup PAC ID 0941499594, 49 clinicians

Practice addresses (Care Compare)

1990 Old Bridge Rd
Suite 201
Woodbridge, VA 22192-2383
Phone (703) 492-6822

Hospital & facility affiliations

  • Mary Washington Hospital Hospital, Fredericksburg, VA, CCN 490022

Merit-based Incentive Payment System (MIPS)

Final score
89.95 of 100Reported as group
Quality
93.11
Promoting interoperability
100
Improvement activities
40
Cost
73.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024183398VAMDGerontology Nurse Practitioner
95015949CAMDPrimary Care Nurse Practitioner
11002390FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
James River Cardiology, LLC Single Specialty CurrentSince Sep 30, 2024 Accepting new patients
Brenton D. Wynn, MD Inc Single Specialty CurrentSince Sep 1, 2023 Accepting new patients
Innovative Pain Management Medical Group Single Specialty Past Accepting new patients

Locations

502 Euclid Ave
Ste 200
National City, CA 91950
Phone (619) 434-4019

333 W Harbor Dr
Ste 126
San Diego, CA 92101

445 Charles H Dimmock Pkwy
Ste 100
Colonial Hgts, VA 23834

422 Garrisonville Rd
Ste 104
Stafford, VA 22554
Phone (540) 288-8352

1990 Old Bridge Rd
Ste 101
Woodbridge, VA 22192
Phone (703) 212-6600

1990 Old Bridge Rd
Ste 201
Woodbridge, VA 22192

Interoperability endpoints

  • Direct secure messaging: kasheika.mcneill.1@31267.direct.athenahealth.com

Organizations & group practices 3

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 3

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": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728691200000",
    "number": "1649817016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 OLD BRIDGE RD STE 201",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922383",
            "telephone_number": "703-492-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 OLD BRIDGE RD STE 201",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922383",
            "telephone_number": "703-492-6822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 Euclid Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "National City",
            "state": "CA",
            "postal_code": "919502984",
            "country_code": "US",
            "telephone_number": "619-434-4019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "655 W 8th St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096511",
            "country_code": "US",
            "telephone_number": "323-300-8099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1990 Old Bridge Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "221922383",
            "country_code": "US",
            "telephone_number": "703-492-6822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "422 Garrisonville Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Stafford",
            "state": "VA",
            "postal_code": "225541573",
            "country_code": "US",
            "telephone_number": "540-628-2173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCNEILL",
        "first_name": "KASHEIKA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-04",
        "last_updated": "2024-10-12",
        "certification_date": "2024-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95015949",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11002390",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024183398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.