Provider Demographics
NPI:1952390858
Name:CARDONE, JENNIFER A (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:A
Last Name:CARDONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13855 COURTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:DINWIDDIE
Mailing Address - State:VA
Mailing Address - Zip Code:23841-2254
Mailing Address - Country:US
Mailing Address - Phone:804-469-3731
Mailing Address - Fax:804-320-6636
Practice Address - Street 1:13855 COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:DINWIDDIE
Practice Address - State:VA
Practice Address - Zip Code:23841-2254
Practice Address - Country:US
Practice Address - Phone:804-469-3731
Practice Address - Fax:804-469-5307
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101055260174400000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA13630OtherCIGNA ID
VA1952390858OtherNPI
VA541549651OtherUNITED HEALTHCARE ID
VA5514502OtherAENTA/USH HEALTHCARE ID
VA1143652OtherFIRST HEALTH ID
VA236373OtherANTHEM ID
VA1952390858Medicaid
VA203349OtherSOUTHERN HEALTH ID
VA2116450OtherMAMSI ID
VA236373OtherANTHEM ID