Individual provider Active NPI

Joshua Mathew Nowocin, PA-C

  • Surgical Physician Assistant
  • Salem, VA
National Provider Identifier
1114113032
Registry record updated Jul 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0110-002627 Issued in VA
Practice address
1970 Roanoke Blvd
Salem, VA 24153-6404
Phone
(540) 521-3802
NPI assigned
Sep 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0110-002627 VA Primary

Addresses

Primary practice location

1970 Roanoke Blvd
Salem, VA 24153-6404

Mailing address

1970 Roanoke Blvd
Salem, VA 24153-6404
Phone (540) 521-3802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0110-002627VAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Braeburn Emergency Physicians LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jnowocin12332@direct.carilionclinic.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405036800000",
    "number": "1114113032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 ROANOKE BLVD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241536404",
            "telephone_number": "540-521-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 ROANOKE BLVD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241536404",
            "telephone_number": "540-521-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWOCIN",
        "first_name": "JOSHUA",
        "middle_name": "MATHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-25",
        "last_updated": "2014-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110-002627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

Verify at the official NPI Registry.