Individual provider Active NPI

Kathleen Beckman, PNP

  • Pediatric Nurse Practitioner
  • Fredericksburg, VA
National Provider Identifier
1679847073
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024169742 Issued in VA
Practice address
4550 Empire CT
Fredericksburg, VA 22408-1939
Phone
(540) 604-9894
Fax
(540) 604-9895
NPI assigned
Mar 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0024169742 VA Primary

Addresses

Primary practice location

4550 Empire CT
Fredericksburg, VA 22408-1939

Mailing address

125 Olde Greenwich Dr
Suite 160
Fredericksburg, VA 22408-4001
Phone (540) 741-0544

Other names 1

  • Kathleen Berney Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120328000463 VA Practitioner - Nurse Practitioner 5597925529

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PL Pediatrics, PLLC CurrentSince Sep 13, 2014 Accepting new patients
Kidz Docs, PLLC Past Accepting new patients
Trusted Doctors LLC Past Accepting new patients

Locations

4550 Empire Ct
Fredericksburg, VA 22408
Phone (540) 361-1800

Interoperability endpoints

  • Direct secure messaging: kathleen.beckman@tkd.eclinicaldirectplus.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330646400000",
    "number": "1679847073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 OLDE GREENWICH DR",
            "address_2": "SUITE 160",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224084001",
            "telephone_number": "540-741-0544",
            "fax_number": "540-741-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 EMPIRE CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224081939",
            "telephone_number": "540-604-9894",
            "fax_number": "540-604-9895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKMAN",
        "first_name": "KATHLEEN",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2012-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024169742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "BERNEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.