Mical J Kupke, M.D.

Primary specialty

Aerospace Medicine PhysicianTaxonomy code 2083A0100X

License

0101056772 Issued in VA

Practice address

77 Nealy Blvd
Langley Afb, VA 23665-2023

Phone

(757) 764-3260

NPI assigned

Mar 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1811956980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 PELICAN PL",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236922983",
            "telephone_number": "757-225-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 NEALY BLVD",
            "city": "LANGLEY AFB",
            "state": "VA",
            "postal_code": "236652023",
            "telephone_number": "757-764-3260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6501 Mechanicsville Tpke Ste G1",
            "address_purpose": "LOCATION",
            "city": "Mechanicsville",
            "state": "VA",
            "postal_code": "231113698",
            "country_code": "US",
            "telephone_number": "804-522-1501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUPKE",
        "first_name": "MICAL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-18",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "010106772",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101056772",
            "primary": false
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "VA",
            "license": "0101056772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor M Inga, PA-C
• Jennifer Melissa Jacobs, PHARM.D.
• Leigh Gossick Johnson, PH.D.
• Loren M Jones, M.D.
• Adam Koertner
• Lynzy Star Lee
• Joseph J Legan, M.D.
• Brian Logue, PHARMD
• Pamela Mary Loveland, M.D.
• Sara E McAlpin, M.D.

• Aerospace Medicine Physician in Langley Afb, VA
• Providers in Langley Afb, VA by specialty
• Aerospace Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.