Individual provider Active NPI

Renee Cundiff Nauful, FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Forest, VA
National Provider Identifier
1063963874
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024174106 Issued in VA
Practice address
1109 Chesdin Rd
Forest, VA 24551-4471
Phone
(434) 221-6231
NPI assigned
Oct 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024174106 VA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024174106 VA Primary

Addresses

Primary practice location

1109 Chesdin Rd
Forest, VA 24551-4471

Mailing address

1109 Chesdin Rd
Forest, VA 24551-4471
Phone (434) 221-6231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170110001479 VA Practitioner - Nurse Practitioner 0042591893 Reassigns benefits to 3 organizations
I20220706000254 DC Practitioner - Nurse Practitioner 0042591893

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
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (434) 947-3033

3300 Rivermont Ave
Lynchburg, VA 24503-2030
Phone (434) 200-5999

693 Leesville Rd
Lynchburg, VA 24502-2828
Phone (434) 947-5700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024174106VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kuumba Community Health & Wellness Center, Inc. CurrentSince Dec 7, 2020 Accepting new patients
Kuumba Community Health & Wellness Center, Inc. CurrentSince Dec 7, 2020 Accepting new patients
Centra Medical Group, LLC CurrentSince Jan 1, 2025 Accepting new patients
Family Insight Inc CurrentSince Apr 1, 2022 Accepting new patients
Childrens Specialty Group PLLC CurrentSince Mar 1, 2024 Accepting new patients

Locations

10640 Page Ave
Ste 220
Fairfax, VA 22030
Phone (703) 310-7665

140 Vista Centre Dr
Fl 2
Forest, VA 24551
Phone (434) 200-2297

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

680 Oyster Point Rd
Newport News, VA 23606
Phone (757) 668-4673

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

850 Southampton Ave
Norfolk, VA 23510
Phone (757) 668-4673

6800 Paragon Pl
Ste 200
Richmond, VA 23230
Phone (757) 970-0236

3716 Melrose Ave NW
Roanoke, VA 24017
Phone (540) 362-0360

1924 Landstown Centre Way
Virginia Beach, VA 23456
Phone (757) 668-4673

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

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1063963874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 CHESDIN RD",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245514471",
            "telephone_number": "434-221-6231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 CHESDIN RD",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245514471",
            "telephone_number": "434-221-6231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAUFUL",
        "first_name": "RENEE",
        "middle_name": "CUNDIFF",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174106",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024174106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest, VA

Sources for this page

Verify at the official NPI Registry.