Individual provider Active NPI

Kelly Rollins, NP

  • Family Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1902458854
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024177775 Issued in VA
Practice address
1201 Broad Rock Blvd
Richmond, VA 23249-0001
Phone
(540) 370-4468
Fax
(804) 888-9639
NPI assigned
Jul 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024177775 VA Primary

Addresses

Primary practice location

1201 Broad Rock Blvd
Richmond, VA 23249-0001

Mailing address

1201 Broad Rock Blvd
Richmond, VA 23249-0001
Phone (540) 370-4468

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
I20190920000883 VA Practitioner - Nurse Practitioner 6002146883 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024177775VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Physicians CurrentSince Jul 22, 2019 Accepting new patients
Pathology Associates of Fredericksburg PTR Current Accepting new patients
Mary Washington Healthcare Physicians CurrentSince Jul 22, 2019 Accepting new patients

Locations

10 Stafford Lakes Pkwy
Ste 106
Fredericksburg, VA 22406
Phone (540) 370-0295

4535 Spotsylvania Pkwy
Fredericksburg, VA 22408
Phone (540) 374-3160

11 Smokehouse Dr
Ste 101
Fredericksburg, VA 22406
Phone (540) 370-0295

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

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.

NPI Registry JSON

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1902458854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 BROAD ROCK BLVD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232490001",
            "telephone_number": "540-370-4468",
            "fax_number": "804-888-9639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 BROAD ROCK BLVD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232490001",
            "telephone_number": "540-370-4468",
            "fax_number": "804-888-9639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLINS",
        "first_name": "KELLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024177775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.