Individual provider Active NPI

Jennifer Lynn Pike, M.D.

  • Dermatology Physician
  • Virginia Beach, VA
National Provider Identifier
1154652345
Registry record updated Jun 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101250828 Issued in VA
Practice address
1200 First Colonial Rd Ste 200M
Virginia Beach, VA 23454-2207
Phone
(757) 481-4422
Fax
(757) 481-9182
NPI assigned
Jan 27, 2010
Last updated
Jun 11, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 0101250828 VA Primary

Addresses

Primary practice location

1200 First Colonial Rd Ste 200M
Virginia Beach, VA 23454-2207

Mailing address

1200 First Colonial Rd Ste 200M
Virginia Beach, VA 23454-2207
Phone (757) 481-4422

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120105000504 VA Practitioner - Dermatology 9830213016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Medical Branch at Galveston, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Dermatology Inc. of Virginia BeachGroup PAC ID 6305806860, 2 clinicians

Practice addresses (Care Compare)

1200 1St Colonial Rd
Suite 200 M
Virginia BCH, VA 23454-2207
Phone (757) 481-4422

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision11
Removal of skin lesions1623
Skin biopsy443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101250828VAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Inc. of Virginia Beach CurrentSince Nov 1, 2011 Accepting new patients

Locations

1200 First Colonial Rd
Ste 200M
Virginia Beach, VA 23454
Phone (757) 481-4422

1200 First Colonial Rd
Ste 200
Virginia Beach, VA 23454
Phone (757) 481-4422

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1154652345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 FIRST COLONIAL RD STE 200M",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542207",
            "telephone_number": "757-481-4422",
            "fax_number": "757-481-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 FIRST COLONIAL RD STE 200M",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542207",
            "telephone_number": "757-481-4422",
            "fax_number": "757-481-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIKE",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-27",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101250828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.