NPIMap

Organization Active NPI

Little Clinic of VA LLC

  • Family Nurse Practitioner
  • Henrico, VA
National Provider Identifier
1225440076
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
LITTLE CLINIC OF VA LLC
Practice address
9000 Staples Mill Rd
Henrico, VA 23228-2021
Phone
(804) 977-9526
NPI assigned
May 28, 2014
Last updated
Sep 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Authorized official

Name
Thomas Shelly
Title
VP
Phone
(513) 762-7042

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

9000 Staples Mill Rd
Henrico, VA 23228-2021

Mailing address

PO Box 932958
Cleveland, OH 44193-0028
Phone (615) 425-4291

Other identifiers 1

IdentifierTypeStateIssuer
2014212603MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140824000049 VA Part B Supplier - Clinic/Group Practice 2961620596 Receives reassigned benefits from 37 practitioners
Practice locations: Mechanicsville, VA; North Chesterfield, VA; Midlothian, VA; Henrico, VA; Chester, VA

National Provider Directory

National Provider Directory

Locations

1017 University Blvd
Suffolk, VA 23435
Phone (757) 335-4537

Practitioners & affiliated clinicians

Practitioners 39

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.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788480000000",
    "number": "1225440076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028",
            "telephone_number": "615-425-4291",
            "fax_number": "615-891-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 STAPLES MILL RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232282021",
            "telephone_number": "804-977-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE CLINIC OF VA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-28",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A",
        "authorized_official_last_name": "SHELLY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "513-762-7042"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2014212603",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; 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.