Individual provider Active NPI

Nicole Bland, FNP-BC

  • Family Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1053075622
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024183009 Issued in VA
Practice address
2621 Grove Ave
Richmond, VA 23220-4308
Phone
(804) 254-5335
NPI assigned
Oct 28, 2021
Last updated
Sep 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024183009 VA
Family Nurse Practitioner 363LF0000X 0024183009 VA Primary

Addresses

Primary practice location

2621 Grove Ave
Richmond, VA 23220-4308

Mailing address

2621 Grove Ave
Richmond, VA 23220-4308
Phone (804) 254-5335

Other names 1

  • Nicole Renee Brown Former 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
I20220211000387 VA Practitioner - Nurse Practitioner 6901299106 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Healthcare of Central Virginia IncGroup PAC ID 9234118340, 34 clinicians

Practice addresses (Care Compare)

2621 Grove Ave
Richmond, VA 23220-4308
Phone (804) 254-5100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.71 of 100Reported as group
Quality
73.52
Promoting interoperability
99
Improvement activities
40
Cost
75.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024183009VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Healthcare of Central Virginia Inc CurrentSince Feb 28, 2022 Accepting new patients
Kindred Community Cares Inc. CurrentSince Jan 8, 2025 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

3277 S Crater Rd
Ste D
Petersburg, VA 23805
Phone (301) 752-4611

2621 Grove Ave
Richmond, VA 23220
Phone (804) 252-5433

Interoperability endpoints

  • Direct secure messaging: nicole.bland.1@33450.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1053075622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 GROVE AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232204308",
            "telephone_number": "804-254-5335",
            "fax_number": "804-254-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 GROVE AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232204308",
            "telephone_number": "804-254-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAND",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-28",
        "last_updated": "2022-09-20",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024183009",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024183009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "BROWN",
            "middle_name": "RENEE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.