Individual provider Active NPI

Kendell Nicole Cobb, MPA, PA-C

  • Physician Assistant
  • Fredericksburg, VA
National Provider Identifier
1679066070
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110006231 Issued in VA
Practice address
10004 Southpoint Pkwy
Fredericksburg, VA 22407-2705
Phone
(540) 252-3535
NPI assigned
Jun 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110006231 VA Primary

Addresses

Primary practice location

10004 Southpoint Pkwy
Fredericksburg, VA 22407-2705

Mailing address

3508 Cedar LN
Portsmouth, VA 23703-3804
Phone (757) 537-6418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20181004002559 VA Practitioner - Physician Assistant 7113279985 Reassigns benefits to 2 organizations
I20230516000098 NC Practitioner - Physician Assistant 7113279985

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Virginia Carenow Urgent Care LLCGroup PAC ID 4284902057, 55 clinicians

Practice addresses (Care Compare)

10004 Southpoint Pkwy
Fredericksburg, VA 22407-2705
Phone (540) 252-3535

300 N Washngton Hwy
Ashland, VA 23005-1626
Phone (804) 537-2905

46200 Potomac Run PLZ
Sterling, VA 20164-6622
Phone (571) 313-5087

4901 Plank Rd
Fredericksburg, VA 22407-6625
Phone (540) 870-6540

5215 W Broad St
Richmond, VA 23230-3009
Phone (804) 554-5688

6100 Harbourside Centre Loop
Midlothian, VA 23112-2170
Phone (804) 639-7555

6296 Mechanicsville Tpke
Mechanicsville, VA 23111-4577
Phone (804) 459-8300

Hospital & facility affiliations

  • Spotsylvania Regional Medical Center Hospital, Fredericksburg, VA, CCN 490141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110006231VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bettermed of North Carolina PLLC PastSince Sep 21, 2019 Accepting new patients

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 1

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": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1679066070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 CEDAR LN",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237033804",
            "telephone_number": "757-537-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 SOUTHPOINT PKWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224072705",
            "telephone_number": "540-252-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "KENDELL",
        "middle_name": "NICOLE",
        "credential": "MPA, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.