Active NPI
Natalie Esannason Taylor, PA-C
- Physician Assistant
- Virginia Beach, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110003051
- Practice address
- 1060 First Colonial Road
Tidewater Integrated Medical Services, PLLC
Virginia Beach, VA 23454-3002 - Phone
- (757) 340-3489
- Fax
- (757) 340-4278
- NPI assigned
- Jul 13, 2009
- Last updated
- Sep 16, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C0004005 | MD | |
| Physician Assistant | 363A00000X | 0110003051 | VA | Primary |
Addresses
Primary practice location
1060 First Colonial Road
Tidewater Integrated Medical Services, PLLC
Virginia Beach, VA 23454-3002
Mailing address
PO Box 2546
Virginia BCH, VA 23450-2546
Phone (757) 340-3489
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
150 Riverside Pkwy
FL 1
Fredericksburg, VA 22406-1094
Phone (732) 813-0799
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C0004005 | MD | MD | Physician Assistant |
| 0110003051 | VA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Better Outcomes LT Care LLC | Current | Accepting new patients | |
| Newbridge Spine and Pain Center LLC | Past | Accepting new patients |
Locations
6160 Kempsville Cir
Ste 325A
Norfolk, VA 23502
Phone (757) 354-2885
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.
-
- Multi-Specialty Clinic/Center
- Norfolk, VA
- NPI 1467246256
-
- Geriatric Medicine (Internal Medicine) Physician
- Norfolk, VA
- NPI 1225557556
-
- Geriatric Medicine (Internal Medicine) Physician
- Norfolk, VA
- NPI 1225720501
-
dba American Physiatry
- Physical Medicine & Rehabilitation Physician
- Virginia Beach, VA
- NPI 1255168894
-
- Specialist
- Frederick, MD
- NPI 1790921450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316131200000",
"number": "1114156031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2546",
"city": "VIRGINIA BCH",
"state": "VA",
"postal_code": "234502546",
"telephone_number": "757-340-3489",
"fax_number": "757-340-4278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1060 FIRST COLONIAL ROAD",
"address_2": "TIDEWATER INTEGRATED MEDICAL SERVICES, PLLC",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234543002",
"telephone_number": "757-340-3489",
"fax_number": "757-340-4278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "NATALIE",
"middle_name": "ESANNASON",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-13",
"last_updated": "2011-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C0004005",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110003051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.