Individual provider Active NPI

Mily J. Kannarkat, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Norfolk, VA
National Provider Identifier
1740405364
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
0101249801 Issued in VA
Practice address
825 Fairfax Ave
Suite 201
Norfolk, VA 23507-1914
Phone
(757) 446-7040
Fax
(757) 446-7049
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 0101249801 VA Primary

Addresses

Primary practice location

825 Fairfax Ave
Suite 201
Norfolk, VA 23507-1914

Mailing address

PO Box 936
Norfolk, VA 23501-0936
Phone (757) 446-7040

Other identifiers 14

IdentifierTypeStateIssuer
1740405364OtherVAUNITED HEALTHCARE/MAMSI
PAROtherVAAETNA
-022OtherVATRICARE/CHAMPUS
1740405364OtherVAVIRGINIA PREMIER HEALTH PLAN
427872OtherVAANTHEM BC/BS
5917498MedicaidNC
1740405364MedicaidVA
PAROtherVACORVEL
PAROtherVAMULTIPLAN
PAROtherVAVIRGINIA HEALTH NETWORK
PAROtherVACIGNA
1740405364OtherVAFIRST HEALTH NETWORK/SOUTHERN HEALTH/COVENTRY NATIONAL
PAROtherVAUSA MANAGED CARE
10077552OtherVAOPTIMA HEALTH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110630000105 VA Practitioner - Geriatric MedicinePractitioner - Internal Medicine 1355537986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Eastern Virginia Medical School, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

825 Fairfax Ave
Norfolk, VA 23507-1914
Phone (757) 446-7040

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Evms Academic Physicians and Surgeons Health Services Foundation CurrentSince Jul 18, 2011 Accepting new patients

Locations

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

721 Fairfax Ave
Ste 431A
Norfolk, VA 23507
Phone (757) 446-7040

825 Fairfax Ave
Ste 201
Norfolk, VA 23507
Phone (757) 446-7040

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.

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.

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    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1740405364",
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        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235010936",
            "telephone_number": "757-446-7040",
            "fax_number": "757-446-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE",
            "address_2": "SUITE 201",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-7040",
            "fax_number": "757-446-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNARKAT",
        "first_name": "MILY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "VA",
            "license": "0101249801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
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        },
        {
            "code": "01",
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            "issuer": "TRICARE/CHAMPUS",
            "identifier": "-022",
            "state": "VA"
        },
        {
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        },
        {
            "code": "01",
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            "identifier": "427872",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5917498",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740405364",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORVEL",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH NETWORK/SOUTHERN HEALTH/COVENTRY NATIONAL",
            "identifier": "1740405364",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA MANAGED CARE",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH",
            "identifier": "10077552",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.