Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Koda Brinker, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1043055502

Koda Brinker, PMHNP-BC is a Nurse Practitioner in Fairfax, Virginia. Qualified in 2024, 2 years ago. Practices with Kennedy Medical Group Practice, PC, a 414-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in District of Columbia and Virginia.

Years since qualifying
2
Licensed in
DC, VA
In the registry since
2024
Specialties on file
2
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

10304 Eaton Pl Ste 100
Fairfax, VA 22030-2221
Phone: (571) 463-8620
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 1140 3rd St Ne Ste 200, Washington, DC 20002-7899 — (571) 463-8620
  • 1629 K St Nw Ste 300, Washington, DC 20006-1631 — (571) 463-8620
  • 800 S Frederick Ave Ste 200, Gaithersburg, MD 20877-4152 — (571) 463-8620

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 0024190559 (VA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence NP500013147 (DC)

Record details

NPI number1043055502
Entity typeIndividual (Type 1)
GenderMale
Credentials PMHNP-BC
Sole proprietorYes
NPI enumeratedJune 27, 2024
Last updated in NPPESNovember 26, 2024
Certification dateNovember 26, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Kennedy Medical Group Practice, P.C. — 414 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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