Advanced Practice Adult-Gerontology

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

0017142291 Issued in VA

Legal business name

ADVANCED PRACTICE ADULT-GERONTOLOGY

Practice address

5140 Hatcher Rd
Fairview Home
Dublin, VA 24084-4802

Phone

(276) 431-4200

NPI assigned

Oct 6, 2015

Last updated

Oct 6, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel K Spencer, MSN,AGPCP,BCNPI 1376927590

Title

Owner

Phone

(276) 768-9058

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Keith Spencer, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Dublin, VA
  • NPI 1376927590
  Medicare reassignment NPD Authorized official
• Nancy Ann Marshall, FNP

  • Family Nurse Practitioner
  • Woodlawn, VA
  • NPI 1033461579
  NPD (past)
• David Glenn Parker, MD

  • Family Medicine Physician
  • Marion, VA
  • NPI 1255370003
  NPD (past)

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444089600000",
    "number": "1194195834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 PINEY VIEW LN",
            "city": "MOUTH OF WILSON",
            "state": "VA",
            "postal_code": "243633694",
            "telephone_number": "276-768-9058",
            "fax_number": "276-783-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 HATCHER RD",
            "address_2": "FAIRVIEW HOME",
            "city": "DUBLIN",
            "state": "VA",
            "postal_code": "240844802",
            "telephone_number": "276-431-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PRACTICE ADULT-GERONTOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-768-9058",
        "authorized_official_credential": "MSN,AGPCP,BC"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0017142291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adult & Child - Family Counseling Inc
• Alvin Alexander
• Anderson Audiology (Hearing Aid Sales & Service, Inc)
• Janice Anderson, AU. D.
• April Loving Andrews, FNP
• Charles Samuel Averette, R.PH.

• Gerontology Nurse Practitioner in Dublin, VA
• Providers in Dublin, VA by specialty
• Gerontology Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.