NPIMap

Individual provider Active NPI

Kaitlin Mahoney

  • Sports Medicine (Family Medicine) Physician
  • Blacksburg, VA
National Provider Identifier
1871034850
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
0102206749 Issued in VA
Practice address
250 S Main Street
Suite 224a
Blacksburg, VA 24060-4726
Phone
(540) 552-7133
Fax
(540) 552-7143
NPI assigned
Mar 10, 2017
Last updated
Mar 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Sports Medicine (Family Medicine) Physician 207QS0010X 0102206749 VA Primary

Addresses

Primary practice location

250 S Main Street
Suite 224a
Blacksburg, VA 24060-4726

Mailing address

1924 Alcoa Hwy # U-67
Knoxville, TN 37920-1511
Phone (865) 305-9350

Other practice location 1

1924 Alcoa Hwy # U-67
Knoxville, TN 37920-1511
Phone (865) 305-9350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210818002427 VA Practitioner - Family Practice 6608120324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthovirginia IncGroup PAC ID 0547157224, 570 clinicians

Practice addresses (Care Compare)

250 S Main St
Suite 224a
Blacksburg, VA 24060-4726
Phone (540) 552-7133

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.85 of 100Reported as group
Quality
90.74
Promoting interoperability
100
Improvement activities
40
Cost
78.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102206749VAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthovirginia, Inc. CurrentSince Sep 13, 2021 Accepting new patients
Orthovirginia, Inc CurrentSince Sep 13, 2021 Accepting new patients
Orthovirginia Inc Current Accepting new patients

Locations

250 S Main St
Ste 224A
Blacksburg, VA 24060
Phone (540) 552-7122

111 Saunders Ln
#E
Bluefield, VA 24605
Phone (276) 322-7649

8200 Meadowbridge Rd
Ste 200
Mechanicsville, VA 23116
Phone (804) 560-5595

1115 Boulders Pkwy
Ste 200
North Chesterfield, VA 23225
Phone (804) 327-9242

Interoperability endpoints

  • Direct secure messaging: kmahoney30464@direct.orthovirginia.com

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 7

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": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1871034850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HWY # U-67",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201511",
            "telephone_number": "865-305-9350",
            "fax_number": "865-305-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S MAIN STREET",
            "address_2": "SUITE 224A",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240604726",
            "telephone_number": "540-552-7133",
            "fax_number": "540-552-7143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1924 Alcoa Hwy # U-67",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379201511",
            "country_code": "US",
            "telephone_number": "865-305-9350",
            "fax_number": "865-305-9353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "KAITLIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-10",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "VA",
            "license": "0102206749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

Verify at the official NPI Registry.