Provider Demographics
NPI:1205854023
Name:WINCHESTER ORTHOPAEDIC ASSOCIATES LTD
Entity Type:Organization
Organization Name:WINCHESTER ORTHOPAEDIC ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CPC
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:B
Authorized Official - Last Name:KERNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-667-8975
Mailing Address - Street 1:128 MEDICAL CIR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3322
Mailing Address - Country:US
Mailing Address - Phone:540-667-8975
Mailing Address - Fax:540-667-6589
Practice Address - Street 1:128 MEDICAL CIR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3322
Practice Address - Country:US
Practice Address - Phone:540-667-8975
Practice Address - Fax:540-667-6589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207X00000X, 225100000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC01482Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER