Individual provider Active NPI

Jared Kirkbride, PA

  • Physician Assistant
  • Midlothian, VA
National Provider Identifier
1851831259
Registry record updated Mar 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5420 Creek Heights Dr
Midlothian, VA 23112-6266
Phone
(850) 374-1858
NPI assigned
Mar 3, 2017
Last updated
Mar 3, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2017

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 Primary

Addresses

Primary practice location

5420 Creek Heights Dr
Midlothian, VA 23112-6266

Mailing address

5420 Creek Heights Dr
Midlothian, VA 23112-6266

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
I20170621000000 VA Practitioner - Physician Assistant 2466720289 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1510 N 28TH St
Richmond, VA 23223-5311

5801 Bremo Rd
Richmond, VA 23226-1907
Phone (804) 764-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Mar 1, 2023 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Mar 1, 2023 Accepting new patients

Locations

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1851831259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 CREEK HEIGHTS DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231126266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 CREEK HEIGHTS DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231126266",
            "telephone_number": "850-374-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKBRIDE",
        "first_name": "JARED",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-03",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.