Individual
DR. JOHN G KENERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1708 OLD DONATION PARKWAY, VIRGINIA BEACH, VA 23454-3064
(757) 395-5300
(757) 213-9341
Mailing address
5700 CLEVELAND STREET, SUITE 228, VIRGINA BEACH, VA 23462-1752
(757) 499-2825
(757) 499-2825
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101034324
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-001
TRICARE/CHAMPUS
VA
05
—
006016359
—
VA
01
—
05912
BCBS
NC
01
—
10011413
SHP OHP
VA
01
—
15573
OPTIMA/SENTARA
VA
05
—
1932158649
—
VA
01
—
239706
ANTHEM
VA
01
—
332623
ANTHEM BCBS
VA
01
—
428965
UHC/MAMSI
—
05
—
8905912
—
NC
01
—
PAR
CIGNA
VA
Enumeration date
05/09/2006
Last updated
07/21/2022
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