Individual provider Active NPI

Mirjam C Molenaar, NP

  • Nurse Practitioner
  • Waynesboro, VA
National Provider Identifier
1225226533
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024167577 Issued in VA
Practice address
201 Lew Dewitt Blvd Ste a
Waynesboro, VA 22980-1663
Phone
(540) 245-7940
Fax
(540) 245-7941
NPI assigned
Oct 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024167577 VA Primary

Addresses

Primary practice location

201 Lew Dewitt Blvd Ste a
Waynesboro, VA 22980-1663

Mailing address

PO Box 388
Fishersville, VA 22939-0388
Phone (540) 213-0277

Other practice location 1

78 Medical Center Dr
Fishersville, VA 22939-2332
Phone (540) 932-4444

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mirjam.molenaar.1@14718.direct.athenahealth.com

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
I20080124000568 VA Practitioner - Nurse Practitioner 1052493426 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Augusta Medical GroupGroup PAC ID 3678632544, 409 clinicians

Practice addresses (Care Compare)

2570 Stuarts Draft Hwy
Stuarts Draft, VA 24477-3237
Phone (540) 245-7880

53 S Medical Park Dr
Fishersville, VA 22939-2333
Phone (540) 332-5687

851 Statler Blvd
Suite B
Staunton, VA 24401-4894
Phone (540) 245-7470

9 S Medical Park Dr
Fishersville, VA 22939-2333
Phone (540) 245-7350

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024167577VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shenandoah Emergency Medicine Specialists LLC CurrentSince Nov 22, 2009 Accepting new patients

Locations

78 Medical Center Dr
Fishersville, VA 22939
Phone (540) 245-7216

Interoperability endpoints

  • Direct secure messaging: mirjam.molenaar.1@14718.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1225226533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229390388",
            "telephone_number": "540-213-0277",
            "fax_number": "540-213-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LEW DEWITT BLVD STE A",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229801663",
            "telephone_number": "540-245-7940",
            "fax_number": "540-245-7941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "78 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Fishersville",
            "state": "VA",
            "postal_code": "229392332",
            "country_code": "US",
            "telephone_number": "540-932-4444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLENAAR",
        "first_name": "MIRJAM",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024167577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mirjam.molenaar.1@14718.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "address_1": "201 Lew DeWitt Blvd Ste A",
            "city": "Waynesboro",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229801663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waynesboro, VA

Sources for this page

Verify at the official NPI Registry.