Individual provider Active NPI

Kenneth J. Cherry

  • Vascular Surgery Physician
  • Norfolk, VA
National Provider Identifier
1750450375
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
0101027681 Issued in VA
Practice address
600 Gresham Dr Ste 8620
Norfolk, VA 23507-1904
Phone
(757) 395-1600
Fax
(757) 625-0433
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 0101027681 VA Primary

Addresses

Primary practice location

600 Gresham Dr Ste 8620
Norfolk, VA 23507-1904

Mailing address

600 Gresham Dr Ste 8620
Norfolk, VA 23507-1904
Phone (757) 395-1600

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
I20040212000052 VA Practitioner - Vascular SurgeryPractitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 8123912946 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101027681VAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Vascular Surgery CurrentSince Feb 15, 2019 Accepting new patients
University of Virginia Physicians Group CurrentSince Jan 12, 2004 Accepting new patients

Locations

1215 Lee St
Fl 2
Charlottesville, VA 22908
Phone (434) 243-6628

500 Ray C Hunt Dr
Charlottesvle, VA 22903
Phone (434) 924-2224

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

600 Gresham Dr
Ste 8620
Norfolk, VA 23507
Phone (757) 388-6402

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

Organizations & group practices 2

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1750450375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR STE 8620",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-395-1600",
            "fax_number": "757-625-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR STE 8620",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-395-1600",
            "fax_number": "757-625-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERRY",
        "first_name": "KENNETH",
        "middle_name": "J.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0101027681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.