Individual provider Active NPI

Nicole Robertson, RPRS

  • Peer Specialist
  • Winchester, VA
National Provider Identifier
1124847561
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
0735001079 Issued in VA
Practice address
337 Westside Station Dr
Winchester, VA 22601-2840
Phone
(540) 536-4881
NPI assigned
Oct 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 0735001079 VA Primary

Addresses

Primary practice location

337 Westside Station Dr
Winchester, VA 22601-2840

Mailing address

337 Westside Station Dr
Winchester, VA 22601-2840
Phone (540) 536-4881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0735001079VAMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1727913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1124847561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 WESTSIDE STATION DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012840",
            "telephone_number": "540-536-4881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 WESTSIDE STATION DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012840",
            "telephone_number": "540-536-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "NICOLE",
        "credential": "RPRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-03",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "VA",
            "license": "0735001079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.