Individual provider Active NPI

Deanna Lynn Kline, AGNP

  • Adult Health Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1841702107
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0024175549 Issued in VA
Practice address
4660 Haygood Rd
Virginia Beach, VA 23455-5436
Phone
(757) 460-0243
Fax
(757) 460-0243
NPI assigned
Oct 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0024175549 VA Primary

Addresses

Primary practice location

4660 Haygood Rd
Virginia Beach, VA 23455-5436

Mailing address

1100 Highlands CT
Chesapeake, VA 23320-8280
Phone (757) 641-3818

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
I20180507000583 VA Practitioner - Nurse Practitioner 7113281759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Reboot Functional Health Care CorporationGroup PAC ID 1052796604, 5 clinicians

Practice addresses (Care Compare)

2528 Las Brisas Dr
Virginia Beach, VA 23456-4264
Phone (757) 301-6985

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024175549VAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Family Practice, P.C. CurrentSince Mar 12, 2018 Accepting new patients
Reboot Functional Health Care Corporation CurrentSince Sep 2, 2024 Accepting new patients
Beach Counseling, LLC PastSince Jul 11, 2018 Accepting new patients

Locations

4660 Haygood Rd
Virginia Beach, VA 23455
Phone (757) 275-4850

4660A Haygood Rd
Virginia Beach, VA 23455
Phone (757) 460-0243

2528 Las Brisas Dr
Virginia Beach, VA 23456
Phone (757) 301-6985

2041 Fisher Arc
Ste 140
Virginia Beach, VA 23456
Phone (757) 301-6985

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1841702107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 HIGHLANDS CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233208280",
            "telephone_number": "757-641-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 HAYGOOD RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234555436",
            "telephone_number": "757-460-0243",
            "fax_number": "757-460-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINE",
        "first_name": "DEANNA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-26",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024175549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.