Active NPI
Joshua Mathew Nowocin, PA-C
- Surgical Physician Assistant
- Salem, VA
National Provider Identifier
1114113032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 0110-002627
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110-002627 | VA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Braeburn Emergency Physicians LLC | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
- Emergency Medicine Physician
- Salem, VA
- NPI 1467888263
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.