Individual provider Active NPI

Kathleen S. Kelley, MD

  • Internal Medicine Physician
  • Harrisonburg, VA
National Provider Identifier
1992760797
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101045174 Issued in VA
Practice address
498 University Blvd
Suite F
Harrisonburg, VA 22801
Phone
(540) 432-1700
NPI assigned
Apr 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101045174 VA Primary

Addresses

Primary practice location

498 University Blvd
Suite F
Harrisonburg, VA 22801

Mailing address

498 University Blvd
Suite F
Harrisonburg, VA 22801
Phone (540) 432-1700

Other identifiers 7

IdentifierTypeStateIssuer
3810003016OtherWV MEDICAID
1000870001OtherVADME PROVIDER
1528917OtherVACIGNA
010187257MedicaidVA
190072OtherVAANTHEM/BCBS
329798OtherSOUTHERN HEALTH
20552OtherVAOPTIMA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060524000218 VA Practitioner - Internal Medicine 5597776914 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101045174VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spero Health of Virginia, LLC CurrentSince Apr 9, 2022 Accepting new patients
Saunders & Peavy LLC CurrentSince Aug 19, 2021 Accepting new patients
Dr. K. Michael King Chriopractor PLLC PastSince Apr 1, 2007 Accepting new patients
Sentara RMH Medical Center Past Accepting new patients
Sentara RMH Medical Center Past Accepting new patients
Bridging the Gaps Past Accepting new patients
Energie Wellness Solutions Past Accepting new patients

Locations

155 Franklin Rd
Ste 430
Brentwood, TN 37027
Phone (615) 265-0359

343 Neff Ave
Ste C
Harrisonburg, VA 22801
Phone (540) 432-9996

314 Fairy Street Ext
Ste B
Martinsville, VA 24112
Phone (276) 201-1647

2303 N Augusta St
Ste B
Staunton, VA 24401
Phone (540) 886-0745

Organizations & group practices 7

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1992760797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "498 UNIVERSITY BLVD",
            "address_2": "SUITE F",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "22801",
            "telephone_number": "540-432-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 UNIVERSITY BLVD",
            "address_2": "SUITE F",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "22801",
            "telephone_number": "540-432-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "KATHLEEN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101045174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV MEDICAID",
            "identifier": "3810003016",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME PROVIDER",
            "identifier": "1000870001",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1528917",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010187257",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM/BCBS",
            "identifier": "190072",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "329798",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "20552",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisonburg, VA

Sources for this page

Verify at the official NPI Registry.