Provider Demographics
NPI:1275420390
Name:I3.NGENUITY
Entity type:Organization
Organization Name:I3.NGENUITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:BEARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-660-1598
Mailing Address - Street 1:3020 ASHBY STATION RD FRNT ROYAL
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-7366
Mailing Address - Country:US
Mailing Address - Phone:571-833-0573
Mailing Address - Fax:
Practice Address - Street 1:44679 ENDICOTT DR
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5567
Practice Address - Country:US
Practice Address - Phone:571-833-0573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management