Kelly D Thompson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110004519 Issued in VA

Practice address

2296 Opitz Blvd Ste 230
Woodbridge, VA 22191-3345

Phone

(703) 878-0924

Fax

(703) 878-1037

NPI assigned

Feb 26, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly D Kennedy Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Bayview Physician Services, PC

  • Family Medicine Physician
  • Chesapeake, VA
  • NPI 1508813387
  Medicare reassignment NPD
• Pulmonary Associates of Richmond Inc

  • Specialist
  • Richmond, VA
  • NPI 1144253444
  Medicare reassignment
• Bayview Physician Services, PC

  • Radiology Clinic/Center
  • Suffolk, VA
  • NPI 1699865626
  NPD
• Richard G. Robinson, M.D & Mark J. Clinton, M.D., P.C.

  • Pulmonary Disease Physician
  • Woodbridge, VA
  • NPI 1275625469
  NPD (past)

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

{
    "created_epoch": "1393372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1700201829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2296 OPITZ BLVD STE 230",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913345",
            "telephone_number": "703-878-0924",
            "fax_number": "703-878-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2296 OPITZ BLVD STE 230",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913345",
            "telephone_number": "703-878-0924",
            "fax_number": "703-878-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KELLY",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-26",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "KENNEDY",
            "middle_name": "D",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Georgina Pennell Thompson
• Gwendolyn Thompson
• Jennifer Thompson, NP
• Joan L Thompson, RPH
• Kayla Thompson, FNP
• Leona Williams Thompson, N/A
• Nichele Amelia Thompson
• Laila Thor
• Thread, LLC
• Renee Threlfall

• Physician Assistant in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.