Individual provider Active NPI

Erica Lynn Bagby, FNP-C

  • Family Nurse Practitioner
  • Petersburg, VA
National Provider Identifier
1184909962
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20987 Issued in CA
Practice address
321C Poplar Dr
Petersburg, VA 23805-9306
Phone
(804) 733-5591
Fax
(804) 733-3506
NPI assigned
Oct 12, 2011
Last updated
Mar 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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 20987 CA Primary

Addresses

Primary practice location

321C Poplar Dr
Petersburg, VA 23805-9306

Mailing address

321C Poplar Dr
Petersburg, VA 23805-9306
Phone (804) 733-5591

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
I20151121000366 VA Practitioner - Nurse Practitioner 1254560030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

165 Legrande Ave
Charlotte Court House, VA 23923-3747
Phone (434) 542-5560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Virginia Health Services Inc Current Accepting new patients
Central Virginia Health Services Inc CurrentSince Jul 1, 2016 Accepting new patients
Central Virginia Health Services Inc CurrentSince Jul 1, 2016 Accepting new patients
Central Virginia Health Services Inc Past Accepting new patients

Locations

9950 Courthouse Rd
Charles City, VA 23030
Phone (804) 226-6383

25892 N James Madison Hwy
New Canton, VA 23123
Phone (434) 581-3271

321 Poplar Dr
Ste C
Petersburg, VA 23805
Phone (804) 733-5591

Organizations & group practices 4

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": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1184909962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321C POPLAR DR",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059306",
            "telephone_number": "804-733-5591",
            "fax_number": "804-733-3506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321C POPLAR DR",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059306",
            "telephone_number": "804-733-5591",
            "fax_number": "804-733-3506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGBY",
        "first_name": "ERICA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-12",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "20987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

Verify at the official NPI Registry.