KENJACK MEDICAL LLC
NPI 1528423555
Family Medicine in Norfolk, VA
About Kenjack Medical Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENJACK MEDICAL LLC (NPI 1528423555) is a healthcare organization registered as a family medicine in Norfolk, Virginia and active in the NPI registry since December 2015. The organization lists Garrett M Kelly, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kenjack Medical Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Kenjack Medical LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kenjack Medical LLC's NPI number?
The NPI number for Kenjack Medical LLC is 1528423555. It was assigned to this organization in the NPPES registry on December 17, 2015.
Where is Kenjack Medical LLC located?
Kenjack Medical LLC is located at 951 W 21st St, Norfolk, VA 23517. The listed phone number is (757) 274-4452.
What is Kenjack Medical LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Kenjack Medical LLC enrolled in Medicare?
Yes. Kenjack Medical LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Kenjack Medical LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Kenjack Medical LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Kenjack Medical LLC was last updated on May 1, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kenjack Medical Llc · NPI 1528423555
Family Medicine organization in Norfolk, Virginia. Organization record, active in the CMS NPPES registry since December 17, 2015.
## Identity
- **NPI:** 1528423555 (Entity type: Organization)
- **Enumerated:** December 17, 2015
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Garrett Kelly, PRESIDENT
## Practice location
- **Address:** 951 W 21ST ST, Norfolk, VA 23517-1534
- **Phone:** (757) 274-4452 · **Fax:** (757) 531-7723
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 1, 2017
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Source: [NPI Profile](https://npiprofile.com/npi/1528423555) · Data from the CMS NPPES public registry.