Individual provider Active NPI

Rachael Santos, GNPBC

  • Gerontology Nurse Practitioner
  • Suffolk, VA
National Provider Identifier
1124275748
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0024175211 Issued in VA
Practice address
2800 Godwin Blvd FL 1
Suffolk, VA 23434-8038
Phone
(757) 934-4821
Fax
(757) 934-4276
NPI assigned
Aug 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ00129600 NJ
Gerontology Nurse Practitioner 363LG0600X 0024175211 VA Primary

Addresses

Primary practice location

2800 Godwin Blvd FL 1
Suffolk, VA 23434-8038

Mailing address

2800 Godwin Blvd FL 1
Suffolk, VA 23434-8038
Phone (757) 934-4821

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
I20180123002020 VA Practitioner - Nurse Practitioner 8426317330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

830 Kempsville Rd
2B223
Norfolk, VA 23502-3920
Phone (757) 261-8860

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00129600NJMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Jan 22, 2018 Accepting new patients
Sentara Medical Group PastSince Jan 22, 2018 Accepting new patients

Locations

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

830 Kempsville Rd
Rm 2B223
Norfolk, VA 23502
Phone (757) 261-8860

2800 Godwin Blvd
Fl 1
Suffolk, VA 23434
Phone (757) 934-4821

1060 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 395-2323

Interoperability endpoints

  • Direct secure messaging: rsantos331300@direct.sentara.net

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 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": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1124275748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 GODWIN BLVD FL 1",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348038",
            "telephone_number": "757-934-4821",
            "fax_number": "757-934-4276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 GODWIN BLVD FL 1",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348038",
            "telephone_number": "757-934-4821",
            "fax_number": "757-934-4276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "RACHAEL",
        "name_prefix": "Ms.",
        "credential": "GNPBC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00129600",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024175211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.