NPIMap

Individual provider Active NPI

Nicole Woodman Costanzo, NP

  • Family Nurse Practitioner
  • Midlothian, VA
National Provider Identifier
1154054930
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024184660 Issued in VA
Practice address
13710 St Francis Blvd Ste 600
Midlothian, VA 23114-3267
Phone
(804) 794-6400
Fax
(804) 897-0910
NPI assigned
Jul 8, 2022
Last updated
Oct 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024184660 VA Primary

Addresses

Primary practice location

13710 St Francis Blvd Ste 600
Midlothian, VA 23114-3267

Mailing address

4600 McAuley PL Ste 600
Blue Ash, OH 45242-4778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221121002269 VA Practitioner - Nurse Practitioner 7315315496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11601 Iron Bridge Rd
Suite 200
Chester, VA 23831-1468
Phone (804) 285-6018

13710 St Francis Blvd
Suite 600
Midlothian, VA 23114-3267
Phone (804) 794-6400

5855 Bremo Rd
Suite 306
Richmond, VA 23226-1923
Phone (804) 287-7650

7001 Forest Ave
Richmond, VA 23230-1726

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024184660VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St Marys Hospital of Richmond LLC CurrentSince Nov 7, 2022 Accepting new patients
Bon Secours St Mary's Hospital of Richmond LLC CurrentSince Nov 7, 2022 Accepting new patients
Bon Secours St. Mary's Hospital of Richmond LLC Current Accepting new patients

Locations

213 N Main St
Blackstone, VA 23824
Phone (434) 292-7261

11601 Iron Bridge Rd
Ste 200
Chester, VA 23831
Phone (804) 340-5730

13700 St Francis Blvd
Ste 600
Midlothian, VA 23114
Phone (804) 794-6400

13710 St Francis Blvd
Ste 600
Midlothian, VA 23114
Phone (804) 764-6400

12320 W Broad St
Ste 204
Richmond, VA 23233
Phone (804) 612-2980

5855 Bremo Rd
Ste 306
Richmond, VA 23226
Phone (804) 287-7644

7001 Forest Ave
Ste 200
Richmond, VA 23230
Phone (804) 288-3123

Interoperability endpoints

  • Direct secure messaging: ncostanzo1402055@direct.bsmhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1154054930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MCAULEY PL STE 600",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452424778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13710 ST FRANCIS BLVD STE 600",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231143267",
            "telephone_number": "804-794-6400",
            "fax_number": "804-897-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANZO",
        "first_name": "NICOLE",
        "middle_name": "WOODMAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-08",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024184660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.