Individual provider Active NPI

Emily Fitch, D.O.

  • Family Medicine Physician
  • Norfolk, VA
National Provider Identifier
1164873931
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102205070 Issued in VA
Practice address
1721 Admiral Taussig Blvd
Norfolk, VA 23511-2802
Phone
(612) 382-0916
NPI assigned
Jun 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 0102205070 VA Primary

Addresses

Primary practice location

1721 Admiral Taussig Blvd
Norfolk, VA 23511-2802

Mailing address

1936 Beechwood Rd
Chesapeake, VA 23323-5324
Phone (612) 382-0916

Other practice location 1

200 Mercy Circle
Naval Hospital Camp Pendleton Box 555191
Camp Pendleton, CA 92055
Phone (760) 719-3675

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
I20180717002778 VA Order and Referring Only - Family PracticePractitioner - Family Practice 3274880620

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102205070VAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1164873931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 BEECHWOOD RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233235324",
            "telephone_number": "612-382-0916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 ADMIRAL TAUSSIG BLVD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235112802",
            "telephone_number": "612-382-0916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Mercy Circle",
            "address_2": "Naval Hospital Camp Pendleton Box 555191",
            "address_purpose": "LOCATION",
            "city": "Camp Pendleton",
            "state": "CA",
            "postal_code": "92055",
            "country_code": "US",
            "telephone_number": "760-719-3675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITCH",
        "first_name": "EMILY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102205070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.