Individual provider Active NPI

Kelvin D Kemp, MD

  • Family Medicine Physician
  • Dumfries, VA
National Provider Identifier
1902193980
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101256795 Issued in VA
Practice address
3700 Fettler Park Dr
Dumfries, VA 22025-2050
Phone
(703) 441-7500
NPI assigned
Jun 29, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101256795 VA Primary

Addresses

Primary practice location

3700 Fettler Park Dr
Dumfries, VA 22025-2050

Mailing address

22 Tankard Rd
Stafford, VA 22554-6548
Phone (586) 838-0832

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241104003124 NM Practitioner - Family Practice 1850510322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Mexico Primary Care Group PCGroup PAC ID 8123177391, 6 clinicians

Practice addresses (Care Compare)

179 Howard PL
Suite 1
Las Cruces, NM 88011-8157
Phone (575) 521-8500

Hospital & facility affiliations

  • Ambercare Home Health Home health agency, Las Cruces, NM, CCN 327133
  • Memorial Medical Center Hospital, Las Cruces, NM, CCN 320018
  • Three Crosses Regional Hospital LLC Hospital, Las Cruces, NM, CCN 320091

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101256795VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Olem Residential Services LLC CurrentSince Dec 6, 2022 Accepting new patients
New Mexico Primary Care Group P.C. CurrentSince Jul 7, 2025 Accepting new patients
Associated Cardiology Consultants of New Mexico PastSince Jul 7, 2025 Accepting new patients

Locations

2405 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-5353

179 Howard Pl
Ste 1
Las Cruces, NM 88011
Phone (575) 521-8500

179 Howard Pl
Las Cruces, NM 88011
Phone (575) 521-8500

Interoperability endpoints

  • Direct secure messaging: kelvin.kemp.1@29838.direct.athenahealth.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 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": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1902193980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 TANKARD RD",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225546548",
            "telephone_number": "586-838-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 FETTLER PARK DR",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220252050",
            "telephone_number": "703-441-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP",
        "first_name": "KELVIN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-29",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101256795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dumfries, VA

Sources for this page

Verify at the official NPI Registry.