Individual provider Active NPI

Kimberly Christine Frye, P.A.

  • Physician Assistant
  • Norfolk, VA
National Provider Identifier
1831104710
Registry record updated Apr 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110001262 Issued in VA
Practice address
171 Kempsville Rd
#201
Norfolk, VA 23502-4700
Phone
(757) 668-6550
Fax
(757) 893-6024
NPI assigned
Jul 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110001262 VA Primary

Addresses

Primary practice location

171 Kempsville Rd
#201
Norfolk, VA 23502-4700

Mailing address

Childrens Surgical Specialty Group Inc
PO Box 631617
Baltimore, MD 21263-1617
Phone (757) 668-6550

Other identifiers 2

IdentifierTypeStateIssuer
006406971MedicaidVA
35573POtherVAOPTIMA/SENTARA HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110001262VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Surgical Specialty Group, Inc Past Accepting new patients
Vann-Virginia Center for Orthopaedics PC Past Accepting new patients
Vann-Virginia Center for Orthopaedics PC Past Accepting new patients

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": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240876800000",
    "number": "1831104710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CHILDRENS SURGICAL SPECIALTY GROUP INC",
            "address_2": "PO BOX 631617",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212631617",
            "telephone_number": "757-668-6550",
            "fax_number": "757-893-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 KEMPSVILLE RD",
            "address_2": "#201",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024700",
            "telephone_number": "757-668-6550",
            "fax_number": "757-893-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYE",
        "first_name": "KIMBERLY",
        "middle_name": "CHRISTINE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2009-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006406971",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA/SENTARA HEALTH",
            "identifier": "35573P",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.