Individual provider Active NPI

Laura M Tice, PA

  • Medical Physician Assistant
  • Rockingham, VA
National Provider Identifier
1033461520
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110004049 Issued in VA
Practice address
2006 Health Campus Dr Ste 300
Rockingham, VA 22801-8679
Phone
(540) 689-7400
Fax
(757) 963-9617
NPI assigned
Oct 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 003606 OH
Medical Physician Assistant 363AM0700X 0110004049 VA Primary

Addresses

Primary practice location

2006 Health Campus Dr Ste 300
Rockingham, VA 22801-8679

Mailing address

2006 Health Campus Dr Ste 300
Rockingham, VA 22801-8679
Phone (540) 689-7400

Other identifiers 1

IdentifierTypeStateIssuer
1033461520MedicaidVA

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
I20130104000255 VA Practitioner - Physician Assistant 1456504216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RMH Medical Group LLCGroup PAC ID 7618270729, 254 clinicians

Practice addresses (Care Compare)

136 W Elizabeth St
Harrisonburg, VA 22802-3811

2006 Health Campus Dr
Rockingham, VA 22801-8679

2008 Health Campus Dr
Rockingham, VA 22801-8679
Phone (540) 689-7000

2010 Health Campus Dr
Rockingham, VA 22801-8679
Phone (540) 689-1110

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
003606OHMDMedical Physician Assistant
0110004049VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
RMH Medical Group LLC CurrentSince Apr 1, 2017 Accepting new patients
Rockingham Memorial Hospital Past Accepting new patients

Locations

136 W Elizabeth St
Ste 201
Harrisonburg, VA 22802
Phone (540) 564-5104

2006 Health Campus Dr
Ste 300
Rockingham, VA 22801
Phone (540) 689-5400

1871 Evelyn Byrd Ave
Rockingham, VA 22801
Phone (540) 434-0559

Interoperability endpoints

  • Direct secure messaging: lseavy221361@direct.sentara.net

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1033461520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 HEALTH CAMPUS DR STE 300",
            "city": "ROCKINGHAM",
            "state": "VA",
            "postal_code": "228018679",
            "telephone_number": "540-689-7400",
            "fax_number": "757-963-9617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 HEALTH CAMPUS DR STE 300",
            "city": "ROCKINGHAM",
            "state": "VA",
            "postal_code": "228018679",
            "telephone_number": "540-689-7400",
            "fax_number": "757-963-9617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICE",
        "first_name": "LAURA",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "003606",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110004049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033461520",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockingham, VA

Sources for this page

Verify at the official NPI Registry.