Individual provider Active NPI

Davina Ann Gillespie, FNP

  • Family Nurse Practitioner
  • Hampton, VA
National Provider Identifier
1104597228
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024182802 Issued in VA
Practice address
901 Enterprise Pkwy Ste 900
Hampton, VA 23666-6250
Phone
(757) 827-2480
Fax
(757) 827-2566
NPI assigned
Sep 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024182802 VA Primary

Addresses

Primary practice location

901 Enterprise Pkwy Ste 900
Hampton, VA 23666-6250

Mailing address

125 Edmond Dr
Newport News, VA 23606-2619
Phone (302) 685-3628

Other names 1

  • Davina Ann Kachnovitz 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
I20211117001039 VA Practitioner - Nurse Practitioner 3476942277 Reassigns benefits to 1 organization

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
Tidewater Orthopaedic Associates Inc.Group PAC ID 2466345814, 26 clinicians

Practice addresses (Care Compare)

901 Enterprise Pkwy
Suite 900
Hampton, VA 23666-6250
Phone (757) 827-2480

Hospital & facility affiliations

  • Sentara Williamsburg Regional Medical Center Hospital, Williamsburg, VA, CCN 490066
  • Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093
  • Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044

Merit-based Incentive Payment System (MIPS)

Final score
94.1 of 100Reported as group
Quality
91.92
Promoting interoperability
97
Improvement activities
40
Cost
90.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024182802VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Orthopaedic Associates Inc CurrentSince Nov 1, 2021 Accepting new patients
Tidewater Orthopaedic Associates Inc CurrentSince Nov 1, 2021 Accepting new patients

Locations

901 Enterprise Pkwy
Ste 900
Hampton, VA 23666
Phone (757) 827-2480

7007 Harbour View Blvd
Ste 108
Suffolk, VA 23435
Phone (757) 215-2784

4037 Ironbound Rd
Williamsburg, VA 23188
Phone (757) 206-1004

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.

Hospital & facility affiliations 4

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": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1104597228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 EDMOND DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062619",
            "telephone_number": "302-685-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 ENTERPRISE PKWY STE 900",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666250",
            "telephone_number": "757-827-2480",
            "fax_number": "757-827-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "DAVINA",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024182802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVINA",
            "last_name": "KACHNOVITZ",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.