NPIMap

Individual provider Active NPI

Kaitlin Peatross

  • Family Nurse Practitioner
  • Irving, TX
National Provider Identifier
1780360214
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024187407 Issued in VA
Practice address
4545 Fuller Dr Ste 325
Irving, TX 75038-6530
Phone
(972) 870-5511
Fax
(972) 870-5512
NPI assigned
Jun 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024187407 VA Primary

Addresses

Primary practice location

4545 Fuller Dr Ste 325
Irving, TX 75038-6530

Mailing address

1950 Glenn Mitchell Dr Ste 300
Virginia Beach, VA 23456-0048

Other practice location 1

1950 Glenn Mitchell Dr Ste 300
Virginia Beach, VA 23456-0048
Phone (435) 671-8932

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231023000168 VA Practitioner - Nurse Practitioner 4981050333 Reassigns benefits to 1 organization
I20250129002567 TX Practitioner - Nurse Practitioner 4981050333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Georgetown University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vpa of Texas PLLCGroup PAC ID 7618911660, 67 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

Irving, TX 75038
Phone (972) 870-5511

800 College Pkwy
Lewisville, TX 75077-3503
Phone (972) 420-8543

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024187407VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Sep 9, 2023 Accepting new patients
Vpa of Texas PLLC CurrentSince Jan 2, 2025 Accepting new patients
Vpa of Texas PLLC CurrentSince Jan 2, 2025 Accepting new patients
Vpa of Texas PLLC Current Accepting new patients

Locations

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

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

1950 Glenn Mitchell Dr
Ste 300
Virginia Beach, VA 23456
Phone (757) 507-0305

Interoperability endpoints

  • Direct secure messaging: kpeatross852457@direct.sentara.net
  • Direct secure messaging: kaitlin.peatross.1@32913.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1780360214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 GLENN MITCHELL DR STE 300",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 FULLER DR STE 325",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750386530",
            "telephone_number": "972-870-5511",
            "fax_number": "972-870-5512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 Glenn Mitchell Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234560048",
            "country_code": "US",
            "telephone_number": "435-671-8932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEATROSS",
        "first_name": "KAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024187407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.