Individual provider Active NPI

Juliette Staples

  • Family Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1023566908
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024174011 Issued in VA
Practice address
6530 Hull Street Rd
Richmond, VA 23224-2636
Phone
(804) 674-3425
Fax
(804) 554-5388
NPI assigned
Sep 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024174011 VA Primary

Addresses

Primary practice location

6530 Hull Street Rd
Richmond, VA 23224-2636

Mailing address

6530 Hull Street Rd
Richmond, VA 23224-2636
Phone (804) 674-3425

Other names 1

  • Juliette Staples Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170109000273 VA Practitioner - Nurse Practitioner 4880975739 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PMR Virginia Holding LLCGroup PAC ID 9537576608, 19 clinicians

Practice addresses (Care Compare)

6530 Hull St Rd
Richmond, VA 23224-2636
Phone (804) 674-3425

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Dominion Health System, Inc. CurrentSince Feb 22, 2022 Accepting new patients
PMR Virginia Holding, LLC CurrentSince Jun 1, 2023 Accepting new patients
Southern Dominion Health System, Inc. CurrentSince Feb 22, 2022 Accepting new patients
Southern Dominion Health System, Inc. Current Accepting new patients
Jencare Neighborhood Medical East Richmond, LLC PastSince Sep 4, 2012 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

3806 Mechanicsville Tpke
Richmond, VA 23223
Phone (804) 228-1143

6530 Hull St Rd
Richmond, VA 23224
Phone (804) 674-3425

1508 K V Rd
Victoria, VA 23974
Phone (434) 696-2165

Networks

  • devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Interoperability endpoints

  • Direct secure messaging: juliette.staples@sdhs.directbygreenway.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1023566908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6530 HULL STREET RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232242636",
            "telephone_number": "804-674-3425",
            "fax_number": "804-554-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6530 HULL STREET RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232242636",
            "telephone_number": "804-674-3425",
            "fax_number": "804-554-5388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPLES",
        "first_name": "JULIETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-20",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIETTE",
            "last_name": "STAPLES",
            "credential": "FNP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.