Individual provider Active NPI

John Paul Schaeffer, HIS

  • Hearing Instrument Specialist
  • Virginia Beach, VA
National Provider Identifier
1043826969
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
2101002458 Issued in VA
Practice address
600 N Witchduck Rd Ste 103
Virginia Beach, VA 23462-1947
Phone
(833) 687-8324
Fax
(757) 222-5991
NPI assigned
Sep 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X B201502220 VA
Hearing Instrument Specialist 237700000X 2101002458 VA Primary

Addresses

Primary practice location

600 N Witchduck Rd Ste 103
Virginia Beach, VA 23462-1947

Mailing address

600 N Witchduck Rd Ste 103
Virginia Beach, VA 23462-1947
Phone (833) 687-8324

Other practice location 1

257 Caratoke Hwy Ste B
Moyock, NC 27958-8677
Phone (833) 687-8324 ext. 2

Other identifiers 1

IdentifierTypeStateIssuer
2101002458OtherVAVIRGINIA DEPARTMENT OF PROFESSIONAL AND OCCUPATIONAL REGULATION

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address contact@novacustomtech.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
B201502220VAMDBasic Emergency Medical Technician
2101002458VAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Custom Technologies Inc. CurrentSince Sep 20, 2020 Accepting new patients
Revolution Hearing Hearing Instrument Specialist Past Accepting new patients

Locations

257 Caratoke Hwy
Ste B
Moyock, NC 27958
Phone 8336878324 ext. 2

600 N Witchduck Rd
Ste 103
Virginia Beach, VA 23462
Phone (833) 687-8324

Organizations & group practices 2

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": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1043826969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N WITCHDUCK RD STE 103",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621947",
            "telephone_number": "833-687-8324",
            "fax_number": "757-222-5991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WITCHDUCK RD STE 103",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621947",
            "telephone_number": "833-687-8324",
            "fax_number": "757-222-5991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "257 Caratoke Hwy Ste B",
            "address_purpose": "LOCATION",
            "city": "Moyock",
            "state": "NC",
            "postal_code": "279588677",
            "country_code": "US",
            "telephone_number": "833-687-8324 x2",
            "fax_number": "757-222-5991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHAEFFER",
        "first_name": "JOHN",
        "middle_name": "PAUL",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "VA",
            "license": "B201502220",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "VA",
            "license": "2101002458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA DEPARTMENT OF  PROFESSIONAL AND OCCUPATIONAL REGULATION",
            "identifier": "2101002458",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@novacustomtech.com",
            "affiliation": "N",
            "endpointDescription": "secured email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "secure email https",
            "address_1": "600 N Witchduck Rd Ste 103",
            "city": "Virginia Beach",
            "state": "VA",
            "country_code": "US",
            "postal_code": "234621947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.