NPIMap

Individual provider Active NPI

Kimberly Anne Hlavac, M.D.

  • Family Medicine Physician
  • Midlothian, VA
National Provider Identifier
1770995995
Registry record updated May 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0116026690 Issued in VA
Practice address
13540 Hull Street Rd
St. Francis Family Medicine Residency
Midlothian, VA 23112-2107
Phone
(804) 739-6142
Fax
(804) 739-8923
NPI assigned
May 22, 2014
Last updated
May 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0116026690 VA Primary

Addresses

Primary practice location

13540 Hull Street Rd
St. Francis Family Medicine Residency
Midlothian, VA 23112-2107

Mailing address

13540 Hull Street Rd
St. Francis Family Medicine Residency
Midlothian, VA 23112-2107
Phone (804) 739-6142

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210409002131 WA Practitioner - Family Practice 9739452327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

222 State Ave N
Kent, WA 98030-4544
Phone (253) 372-7788

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0116026690VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Feb 25, 2021 Accepting new patients
Multicare Health System CurrentSince Feb 25, 2021 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System Family Medicine Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

4215 49th Ave NE
Tacoma, WA 98422
Phone (253) 459-7699

521 S K St
Tacoma, WA 98405
Phone (253) 403-2900

Interoperability endpoints

  • Direct secure messaging: khlavac567906@direct.multicare.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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.

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400716800000",
    "number": "1770995995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13540 HULL STREET RD",
            "address_2": "ST. FRANCIS FAMILY MEDICINE RESIDENCY",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122107",
            "telephone_number": "804-739-6142",
            "fax_number": "804-739-8923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13540 HULL STREET RD",
            "address_2": "ST. FRANCIS FAMILY MEDICINE RESIDENCY",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122107",
            "telephone_number": "804-739-6142",
            "fax_number": "804-739-8923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HLAVAC",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2014-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116026690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.