Individual provider Active NPI

Sheila Marie Kepple, PA-C

  • Physician Assistant
  • Fredericksburg, VA
National Provider Identifier
1700185394
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110003474 Issued in VA
Practice address
1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone
(540) 741-3340
Fax
(540) 741-3348
NPI assigned
Mar 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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 0110003474 VA Primary

Addresses

Primary practice location

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453

Mailing address

1101 Sam Perry Blvd
Suite 207
Fredericksburg, VA 22401-4467
Phone (540) 741-3340

Other practice location 1

501 Sunset Ln
Culpeper, VA 22701-3917
Phone (703) 396-5292

Other names 1

  • Sheila Marie Coyazo Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pa.smk@culpeperhealth.direct-ci.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110003474VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fredericksburg Hospitalist Group, P.C. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1700185394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SAM PERRY BLVD",
            "address_2": "SUITE 207",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014467",
            "telephone_number": "540-741-3340",
            "fax_number": "540-741-3348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SAM PERRY BLVD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014453",
            "telephone_number": "540-741-3340",
            "fax_number": "540-741-3348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Sunset Ln",
            "address_purpose": "LOCATION",
            "city": "Culpeper",
            "state": "VA",
            "postal_code": "227013917",
            "country_code": "US",
            "telephone_number": "703-396-5292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEPPLE",
        "first_name": "SHEILA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2020-10-02",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pa.smk@culpeperhealth.direct-ci.net",
            "affiliation": "N",
            "address_1": "501 Sunset Ln",
            "city": "Culpeper",
            "state": "VA",
            "country_code": "US",
            "postal_code": "227013917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHEILA",
            "last_name": "COYAZO",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.