Kristin Sachs Souder, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110-004714 Issued in VA

Practice address

3060 Godwin Blvd
Suffolk, VA 23434-8274

Phone

(757) 935-5310

Fax

(757) 935-5311

NPI assigned

Oct 27, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michumi PLLCGroup PAC ID 5193784395, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ksouder26045@direct.rivhs.com

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.

• Michumi PLLC

  dba MD Express

  • Emergency Medicine Physician
  • Williamsburg, VA
  • NPI 1255388021
  Medicare reassignment Care Compare group
• Bayview Physician Services, PC

  • Family Medicine Physician
  • Chesapeake, VA
  • NPI 1508813387
  Medicare reassignment NPD
• Bayview Physician Services, PC

  dba LMC Radiology

  • Radiology Clinic/Center
  • Suffolk, VA
  • NPI 1699865626
  NPD
• Bayview Medical Center, Inc

  dba LMC Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Suffolk, VA
  • NPI 1568466209
  NPD (past)
• Peninsula Radiological Associates Limited

  • Diagnostic Radiology Physician
  • Newport News, VA
  • NPI 1114030426
  NPD (past)

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1861897365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 WESTERN BRANCH BLVD STE A",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215260",
            "telephone_number": "757-686-3508",
            "fax_number": "757-686-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 GODWIN BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348274",
            "telephone_number": "757-935-5310",
            "fax_number": "757-935-5311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Volvo Pkwy",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233201621",
            "country_code": "US",
            "telephone_number": "757-842-4100",
            "fax_number": "757-410-3562",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2088 S Independence Blvd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234534790",
            "country_code": "US",
            "telephone_number": "757-275-9331",
            "fax_number": "757-416-7656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1168 First Colonial Rd",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234542444",
            "country_code": "US",
            "telephone_number": "757-352-2020",
            "fax_number": "757-352-2021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUDER",
        "first_name": "KRISTIN",
        "middle_name": "SACHS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-27",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-004714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Solid Rock Family Life Center, LLC
• Solid Solutions LLC
• Nicole Louise Solomon, LCSW
• Southeastern ABA PLLC
• Southerncare , Inc. (New Century Hospice)
• Southside Counseling Center, LLC
• Edward Huland Spain, PH. D.
• Rebecca Bobbitt Spalding, RPH

• Physician Assistant in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.

Verify at the official NPI Registry.