Individual provider Active NPI

Annyce Christina Treherne, MD

  • Specialist
  • Hampton, VA
National Provider Identifier
1073770905
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101247612 Issued in VA
Practice address
2207 Executive Dr Ste a
Hampton, VA 23666-2478
Phone
(757) 838-8525
Fax
(757) 838-8527
NPI assigned
May 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101247612 VA Primary

Addresses

Primary practice location

2207 Executive Dr Ste a
Hampton, VA 23666-2478

Mailing address

2207 Executive Dr Ste a
Hampton, VA 23666-2478
Phone (757) 838-8525

Other identifiers 1

IdentifierTypeStateIssuer
0438003934MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Hampton Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131205001293 VA Practitioner - Dermatology 8527293257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Meharry Medical College School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2207 Executive Dr
Suite a
Hampton, VA 23666-2478
Phone (757) 838-8525

Hospital & facility affiliations

  • Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision11
Removal of skin lesions310
Removal or shaving of skin growth1-10
Skin biopsy274

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101247612VAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Treherne Dermatology and Skin C Are Center LLC. CurrentSince Sep 23, 2013 Accepting new patients

Locations

2207 Executive Dr
Ste A
Hampton, VA 23666
Phone (757) 826-1945

Organizations & group practices 1

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": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1073770905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2207 EXECUTIVE DR STE A",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662478",
            "telephone_number": "757-838-8525",
            "fax_number": "757-838-8527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207 EXECUTIVE DR STE A",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662478",
            "telephone_number": "757-838-8525",
            "fax_number": "757-838-8527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREHERNE",
        "first_name": "ANNYCE",
        "middle_name": "CHRISTINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101247612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0438003934",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Hampton",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Hampton",
            "address_1": "2207 Executive Dr Ste A",
            "city": "Hampton",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236662478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.