Individual provider Active NPI

Katherine Sue Paul, NP

  • Nurse Practitioner
  • Chesapeake, VA
National Provider Identifier
1790742385
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024164242 Issued in VA
Practice address
800 Battlefield Blvd N
Chesapeake, VA 23320-4999
Phone
(757) 312-3085
Fax
(757) 923-6237
NPI assigned
Apr 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024164242 VA Primary

Addresses

Primary practice location

800 Battlefield Blvd N
Chesapeake, VA 23320-4999

Mailing address

667 Kingsborough SQ Ste 101
Chesapeake, VA 23320-4999
Phone (757) 312-3085

Other identifiers 3

IdentifierTypeStateIssuer
500030057OtherVARAILROAD MEDICARE
7003974MedicaidNC
7789301MedicaidVA

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
I20101027000089 VA Practitioner - Nurse Practitioner 7315131026 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024164242VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bayview Physician Services, PC CurrentSince Apr 1, 2013 Accepting new patients
Bayview Physician Services, PC CurrentSince Apr 1, 2013 Accepting new patients
Bayview Medical Center, Inc Current Accepting new patients

Locations

20209 Sentara Way
Carrollton, VA 23314
Phone (757) 357-5307

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

2000 Meade Pkwy
Suffolk, VA 23434
Phone (757) 539-0251

Organizations & group practices 3

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1790742385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 KINGSBOROUGH SQ STE 101",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204999",
            "telephone_number": "757-312-3085",
            "fax_number": "757-312-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BATTLEFIELD BLVD N",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204999",
            "telephone_number": "757-312-3085",
            "fax_number": "757-923-6237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "KATHERINE",
        "middle_name": "SUE",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024164242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "500030057",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7003974",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7789301",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.