KETAVIA
NPI 1629936703
Nurse Practitioner - Psychiatric/Mental Health in Midlothian, VA
About Ketavia NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KETAVIA (NPI 1629936703) is a healthcare organization registered as a psychiatric/mental health in Midlothian, Virginia and active in the NPI registry since January 2026. The organization lists Keisha Lopez, Owner, 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)
Ketavia 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 Ketavia, 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 Ketavia's NPI number?
The NPI number for Ketavia is 1629936703. It was assigned to this organization in the NPPES registry on January 15, 2026.
Where is Ketavia located?
Ketavia is located at 5309 Commonwealth Centre Pkwy Ste 105, Midlothian, VA 23112. The listed phone number is (804) 940-8959.
What is Ketavia's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Ketavia enrolled in Medicare?
Yes. Ketavia is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Ketavia?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Ketavia. 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 Ketavia was last updated on January 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.
# Ketavia · NPI 1629936703
Psychiatric/Mental Health organization in Midlothian, Virginia. Organization record, active in the CMS NPPES registry since January 15, 2026.
## Identity
- **NPI:** 1629936703 (Entity type: Organization)
- **Enumerated:** January 15, 2026
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Keisha Lopez, OWNER
## Practice location
- **Address:** 5309 COMMONWEALTH CENTRE PKWY STE 105, Midlothian, VA 23112-2633
- **Phone:** (804) 940-8959 · **Fax:** (804) 308-3362
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 19, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1629936703) · Data from the CMS NPPES public registry.