KATY HUGHES FEDORKO (NPI# 1215557335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215557335 |
| Entity Type | Individual |
| Full Name | KATY HUGHES FEDORKO |
| Practice Address |
100 Emancipation Dr Hampton VA 23667-2906 |
| Mailing Address |
1614 Cougar Ave Norfolk VA 23518-2906 |
| Practice Telephone | 7577229961 |
| Mailing Telephone | 7573748861 |
| Enumeration Date | 2020-04-18 |
| Last Update Date | 2020-07-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
0110007314 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
100 EMANCIPATION DR |
| City | HAMPTON |
| State | VA |
| Zip Code | 23667-2906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073518916 | Therese P Montoya | Physical Medicine & Rehabilitation | 100 Emancipation Dr, Hampton, VA 23667 | 2005-06-16 |
| 1285241570 | Larry N. Wootten | Psychologist | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-09-30 |
| 1487266631 | Jason Jemale Hall | Counselor | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-08-19 |
| 1790395085 | Caitlyn Moody | Pharmacist | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-08-03 |
| 1639788268 | Shan S. Wong | Psychologist | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-07-29 |
| 1205454352 | Charity Seitz | Psychologist | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-07-06 |
| 1629694617 | Michael William Olsavicky | Pharmacist | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-06-25 |
| 1659997914 | John David Kauffman | Pharmacist | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-06-23 |
| 1790301406 | Lineisha Williams | Social Worker | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-06-18 |
| 1144858424 | Fallon Trent | Psychologist | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-03-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124447388 | Brian Pho Bui | Psychiatry & Neurology | Hampton Veterans Affairs 100 Emancipation Dr, Hampton, VA 23667 | 2014-04-15 |
| 1275786741 | Melissa Ann Palka | Nurse Practitioner | Hampton Va Medical Center, 100 Emancipation Dr., Hampton, VA 23667 | 2008-10-28 |
| 1639107741 | Lawrence Monroe Brown Jr. | Social Worker | Hampton Vamc, 100 Emancipation Dr, Hampton, VA 23667 | 2006-06-29 |
| 1578528030 | Harold Steven Smuckler | Family Medicine | Department of Veterans Affairs, Primary Care, 100 Emancipation Lane, Hampton, VA 23667 | 2006-04-19 |
| 1013978451 | Donald Epstein | Psychologist | 1000 Emancipation Drive, Hampton, VA 23667 | 2006-03-28 |
| 1225098593 | Maryanne Schaeffer | Dietitian, Registered | 100 Emancipation Drive, Hampton, VA 23667 | 2006-03-23 |
| 1376074773 | Linda Carol Whitfield | Case Manager/Care Coordinator | 100 Emancipation Drive, Hampton, VA 23667 | 2017-03-27 |
| 1316217516 | Wallace Danny Johnson IIi | Occupational Therapist | 100 Emancipation Drive, Hampton, VA 23667 | 2012-01-04 |
| 1386929164 | Amber Mizuki | Dietitian, Registered | 100 Emancipation Drive, Bldg 116, Hampton, VA 23667 | 2011-10-12 |
| 1447549266 | Irene Nanghui Yi | Pharmacist | 100 Emancipation Dr., Hampton Vamc, Hampton, VA 23667 | 2011-04-01 |
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| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992112163 | Christian Henrik Johansson | Physician Assistant | 901 Enterprise Pkwy Ste 900, Hampton, VA 23666 | 2014-07-18 |
| 1629217021 | Amanda K Watkins | Physician Assistant | 901 Enterprise Pkwy, Suite 900, Hampton, VA 23666-6249 | 2009-02-10 |
| 1174588776 | Gayle Barbuto | Physician Assistant | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2006-04-18 |
| 1215991484 | Mark Andrew Cannon | Physician Assistant | 100 Emancipation Dr, Department of Surgery, Hampton, VA 23667-0001 | 2006-04-14 |
| 1053373621 | Alan David Abrams | Physician Assistant | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2006-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962038042 | Emma Alexandra Rouse | Physician Assistant | 2712 Hatmark St, Vienna, VA 22181-6054 | 2020-03-20 |
| 1861059461 | Daniel P Sherman | Physician Assistant | 43165 Thistledown Ter Apt 241, Broadlands, VA 20148-4075 | 2019-05-20 |
| 1184289753 | Vicenta Hanh-phuoc Tran | Physician Assistant | 7611 Trammell Rd, Annandale, VA 22003-1442 | 2019-05-08 |
| 1649833021 | Karlie Diruzza | Physician Assistant | 2900 Lamb Cir # L760, Christiansburg, VA 24073-6344 | 2019-04-21 |
| 1164983599 | Bradley Pretzer | Physician Assistant | 5115 Cliffhaven Dr, Annandale, VA 22003-4348 | 2019-03-28 |
| 1346757416 | Hinda Yasmin Mezaache | Physician Assistant | 1101 Sam Perry Blvd Ste 219, Fredericksburg, VA 22401-4465 | 2018-01-10 |
| 1265974851 | Gerard Surgical Services, LLC | Physician Assistant | 12220 Chattanooga Plz Ste 121, Midlothian, VA 23112-4865 | 2016-11-14 |
| 1417301607 | Jose Gustavo Espino | Physician Assistant | 6866 Deer Run Dr, Alexandria, VA 22306-1124 | 2016-04-14 |
| 1477915098 | Kelly Egan Weaver | Physician Assistant | 1201 Broad Rock Blvd Richmond Va 23224, Richmond, VA 23249-4915 | 2016-03-23 |
| 1871976522 | Hall Surgical Assistance, LLC | Physician Assistant | 10332 Main St, Suite #344, Fairfax, VA 22030-2410 | 2015-06-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.