Individual provider Active NPI

Katherine Oberdove, PA-C

  • Physician Assistant
  • Fredericksburg, VA
National Provider Identifier
1730635137
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110010514 Issued in VA
Practice address
330 White Oak Rd
Fredericksburg, VA 22405-2792
Phone
(540) 373-2424
NPI assigned
Aug 26, 2016
Last updated
Jan 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 53677 CA
Physician Assistant 363A00000X 50.005242RX OH
Physician Assistant 363A00000X 0110010514 VA Primary

Addresses

Primary practice location

330 White Oak Rd
Fredericksburg, VA 22405-2792

Mailing address

5450 Frantz Rd Ste 360
Dublin, OH 43016-4141

Other practice location 1

513 Shadow Tree Dr
Oceanside, CA 92058-7029
Phone (859) 803-9080

Other practice location 2

70 S Cleveland Ave
Westerville, OH 43081-1397
Phone (614) 839-2115

Other practice location 3

70 S Cleveland Ave
Westerville, OH 43081-1397
Phone (614) 839-2115

Other names 1

  • Katherine Navaro 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
I20250304000458 VA Practitioner - Physician Assistant 0749561058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virginia Urgent Care LLCGroup PAC ID 2062572456, 24 clinicians

Practice addresses (Care Compare)

12581 Milstead Way
Suite 103
Woodbridge, VA 22192-5425
Phone (703) 897-5890

15 S Gateway Dr
Suite 101
Fredericksburg, VA 22406-1231
Phone (540) 368-5603

330 White Oak Rd
Fredericksburg, VA 22405-2792
Phone (540) 373-2424

5825 Plank Rd
Suite 105
Fredericksburg, VA 22407-5207
Phone (540) 785-2727

National Provider Directory

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

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, 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": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1730635137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 FRANTZ RD STE 360",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 WHITE OAK RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224052792",
            "telephone_number": "540-373-2424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "513 Shadow Tree Dr",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "920587029",
            "country_code": "US",
            "telephone_number": "859-803-9080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "70 S Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430811397",
            "country_code": "US",
            "telephone_number": "614-839-2115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "70 S Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430811397",
            "country_code": "US",
            "telephone_number": "614-839-2115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBERDOVE",
        "first_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-26",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53677",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005242RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "NAVARO",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.