Individual provider Active NPI

Jeffry Clark Hatcher, DO

  • Family Medicine Physician
  • Ashburn, VA
National Provider Identifier
1821023920
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102204324 Issued in VA
Practice address
21022 Rocky Knoll SQ Apt 105
Ashburn, VA 20147-5715
Phone
(571) 442-4674
Fax
(402) 800-7635
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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 0102204324 VA Primary

Addresses

Primary practice location

21022 Rocky Knoll SQ Apt 105
Ashburn, VA 20147-5715

Mailing address

PO Box 642117
Omaha, NE 68164-8117
Phone (402) 398-6255

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160128001832 DC Practitioner - Family Practice 1355347451 Reassigns benefits to 2 organizations
I20181219000350 VA Practitioner - Family Practice 1355347451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians
Care Talk Health FL PAGroup PAC ID 3173995966, 31 clinicians

Practice addresses (Care Compare)

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

14139 Potomac Mills Rd
Woodbridge, VA 22192-4644
Phone (703) 257-3000

1890 Metro Ctr Dr
Reston, VA 20190-5286
Phone (703) 709-1500

4849 Rugby Ave
Bethesda, MD 20814-3018
Phone (443) 929-1478

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
471NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Dec 16, 2015 Accepting new patients
Care Talk Health FL PA CurrentSince Jun 1, 2025 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Dec 16, 2015 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Family Medicine CurrentSince Oct 20, 2018 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Family Medicine Current Accepting new patients
Hospital & Medical Foundation of Paris, Inc. Family Medicine Past Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients

Locations

4849 Rugby Ave
Bethesda, MD 20814
Phone (240) 817-7500

2101 E Jefferson St
#4
Rockville, MD 20852

2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

10701 Rosemary Dr
Manassas, VA 20109
Phone (703) 257-3000

14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000

Organizations & group practices 8

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1821023920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 642117",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681648117",
            "telephone_number": "402-398-6255",
            "fax_number": "402-553-5092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21022 ROCKY KNOLL SQ APT 105",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475715",
            "telephone_number": "571-442-4674",
            "fax_number": "402-800-7635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATCHER",
        "first_name": "JEFFRY",
        "middle_name": "CLARK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102204324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "10701 Rosemary Dr",
            "city": "Manassas",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201097282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

Verify at the official NPI Registry.