Individual provider Active NPI

Katelin Jackfert Emory

  • Nurse Practitioner
  • Fairfax, VA
National Provider Identifier
1699130286
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024173156 Issued in VA
Practice address
8505 Arlington Blvd
Fairfax, VA 22031-4621
Phone
(703) 280-1234
NPI assigned
Dec 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024173156 VA Primary

Addresses

Primary practice location

8505 Arlington Blvd
Fairfax, VA 22031-4621

Mailing address

4168 Zinnia LN
Fairfax, VA 22030-6046
Phone (304) 395-0444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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
I20160129000865 DC Practitioner - Nurse Practitioner 7012210750 Reassigns benefits to 2 organizations
I20160229002395 VA Practitioner - Nurse Practitioner 7012210750 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, shared by 24 NPIs, 1,821 clinicians

Practice addresses (Care Compare)

1500 N Beauregard St
Suite 300
Alexandria, VA 22311-1715
Phone (703) 845-1500

3800 Fettler Park Dr
Suite 312
Dumfries, VA 22025-2043
Phone (571) 472-6791

Hospital & facility affiliations

  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024173156VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jan 1, 2017 Accepting new patients
Inova Health Care Services CurrentSince Jan 1, 2017 Accepting new patients
Inova Health Care Services CurrentSince Jun 2, 2023 Accepting new patients

Locations

4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000

1500 N Beauregard St
Ste 300
Alexandria, VA 22311
Phone (703) 845-1500

3800 Fettler Park Dr
Ste 312
Dumfries, VA 22025
Phone (571) 472-6791

8081 Innovation Park Dr
Ste 900
Fairfax, VA 22031
Phone (571) 472-4200

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

8505 Arlington Blvd
Fairfax, VA 22031
Phone (703) 705-2277

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

224D Cornwall St NW
Leesburg, VA 20176
Phone (571) 291-3458

Interoperability endpoints

  • Direct secure messaging: kjackfert203846@soc.inova.org

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 2

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": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1699130286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4168 ZINNIA LN",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306046",
            "telephone_number": "304-395-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8505 ARLINGTON BLVD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314621",
            "telephone_number": "703-280-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMORY",
        "first_name": "KATELIN",
        "middle_name": "JACKFERT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-23",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024173156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.