Individual provider Active NPI

Kevin Garrett

  • Surgery Physician
  • Mechanicsville, VA
National Provider Identifier
1962102038
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0136000763 Issued in VA
Practice address
6421 Gaulding Rd
Mechanicsville, VA 23111-3205
Phone
(804) 502-2760
NPI assigned
Mar 7, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0136000763 VA Primary

Addresses

Primary practice location

6421 Gaulding Rd
Mechanicsville, VA 23111-3205

Mailing address

6421 Gaulding Rd
Mechanicsville, VA 23111-3205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0136000763VAMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1962102038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6421 GAULDING RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231113205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6421 GAULDING RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231113205",
            "telephone_number": "804-502-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-07",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0136000763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.