Kimberly T Prevost

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

License

0001222497 Issued in VA

Practice address

24440 Stone Springs Blvd
Dulles, VA 20166-2247

Phone

(703) 861-7660

NPI assigned

Oct 26, 2018

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dominion Surgical Assistants, LLC

  • Registered Nurse First Assistant
  • Dulles, VA
  • NPI 1962915454
  NPD (past)

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

{
    "created_epoch": "1540512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540512000000",
    "number": "1972070167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25226 JUSTICE DR",
            "city": "SOUTH RIDING",
            "state": "VA",
            "postal_code": "201526011",
            "telephone_number": "703-861-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24440 STONE SPRINGS BLVD",
            "city": "DULLES",
            "state": "VA",
            "postal_code": "201662247",
            "telephone_number": "703-861-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREVOST",
        "first_name": "KIMBERLY",
        "middle_name": "T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-26",
        "last_updated": "2018-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "VA",
            "license": "0001222497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nirav A Patel, PHARM.D.
• Pediatrix Medical Group of the Mid-Atlantic PC
• Michael James Peters, MD
• Christopher Pham, PHARMD
• Shane C Pierce, PA-C
• Saira P Rana, M.D.
• Amy Beckwith Rembold, PA-C
• Reston Hospital Center, LLC
• Gabriel Reyes, M.D.
• Dora Cecilia Rioja-Mazza, MD

• Registered Nurse First Assistant in Dulles, VA
• Providers in Dulles, VA by specialty
• Registered Nurse First Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; 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.