Provider Demographics
NPI: | 1780394072 |
---|---|
Name: | FIELDS, KYLE (RRT, RRT-NPS) |
Entity type: | Individual |
Prefix: | |
First Name: | KYLE |
Middle Name: | |
Last Name: | FIELDS |
Suffix: | |
Gender: | |
Credentials: | RRT, RRT-NPS |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 16 INGLEWOOD DR |
Mailing Address - Street 2: | |
Mailing Address - City: | HAMPTON |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 23666-3510 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 601 CHILDRENS LN |
Practice Address - Street 2: | |
Practice Address - City: | NORFOLK |
Practice Address - State: | VA |
Practice Address - Zip Code: | 23507-1971 |
Practice Address - Country: | US |
Practice Address - Phone: | 757-668-8800 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2022-11-29 |
Last Update Date: | 2025-04-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
VA | 0117009794 | 227900000X |
2279E0002X, 2279G1100X, 2279P3900X, 2279P4000X, 2279C0205X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2279C0205X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Critical Care |
No | 227900000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | |
No | 2279E0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Emergency Care |
No | 2279G1100X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | General Care |
No | 2279P3900X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Neonatal/Pediatrics |
No | 2279P4000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Patient Transport |