Active NPI
Kathleen St. John Iudica, M.D.
- Family Medicine Physician
- Harrisonburg, VA
National Provider Identifier
1821099508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0101223187
- Practice address
- 1831 Reservoir St
Harrisonburg, VA 22801-8743 - Phone
- (540) 433-9151
- Fax
- (540) 433-0547
- NPI assigned
- Aug 3, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101223187 | VA | Primary |
Addresses
Primary practice location
1831 Reservoir St
Harrisonburg, VA 22801-8743
Mailing address
1831 Reservoir St
Harrisonburg, VA 22801-8743
Phone (540) 433-9151
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 286698 | Other | VA | ANTHEM ID |
| 005620040 | Other | VA | VIRGINIA PREMIER |
| 113977 | Other | VA | OPTIMA |
| 147636 | Other | VA | SOUTHERN HEALTH ID |
| 005620040 | Medicaid | VA |
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120604000084 | VA | Practitioner - Family Practice | 7517121536 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Maryland Medical College, 1998
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Harrisonburg Family Practice Associates PC
Practice addresses (Care Compare)
1831 Reservoir St
Harrisonburg, VA 22801-8743
Phone (540) 433-9151
Hospital & facility affiliations
- Sentara Home Care Services
- Interim Healthcare - Charlottesville
- Amedisys Home Health Care
- First Choice Home Health Services, LLC
- Sentara RMH Medical Center
- University of Virginia Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101223187 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harrisonburg Family Practice Associates PC | Current | Accepting new patients |
Locations
1831 Reservoir St
Harrisonburg, VA 22801
Phone (540) 433-9151
Organizations & group practices 1
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.
-
- Primary Care Clinic/Center
- Harrisonburg, VA
- NPI 1003832999
VA
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Harrisonburg, VA
- NPI 1194028803
-
- Home Health Agency
- Staunton, VA
- NPI 1073794863
-
- Home Health Agency
- Harrisonburg, VA
- NPI 1588730436
-
- Home Health Agency
- Charlottesville, VA
- NPI 1225068190
-
- General Acute Care Hospital
- Charlottesville, VA
- NPI 1780630608
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269820800000",
"number": "1821099508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1831 RESERVOIR ST",
"city": "HARRISONBURG",
"state": "VA",
"postal_code": "228018743",
"telephone_number": "540-433-9151",
"fax_number": "540-433-0547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1831 RESERVOIR ST",
"city": "HARRISONBURG",
"state": "VA",
"postal_code": "228018743",
"telephone_number": "540-433-9151",
"fax_number": "540-433-0547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IUDICA",
"first_name": "KATHLEEN",
"middle_name": "ST. JOHN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-03",
"last_updated": "2010-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0101223187",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM ID",
"identifier": "286698",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA PREMIER",
"identifier": "005620040",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMA",
"identifier": "113977",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTHERN HEALTH ID",
"identifier": "147636",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005620040",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Harrisonburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.