Active NPI
Michelle Gideon
- Family Nurse Practitioner
- Virginia Beach, VA
National Provider Identifier
1225499676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 0024173385
- Practice address
- 397 Little Neck Rd
Suite 100
Virginia Beach, VA 23452-5765 - Phone
- (757) 395-1600
- Fax
- (757) 961-5938
- NPI assigned
- Mar 14, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024173385 | VA | Primary |
Addresses
Primary practice location
397 Little Neck Rd
Suite 100
Virginia Beach, VA 23452-5765
Mailing address
397 Little Neck Rd
Suite 100
Virginia Beach, VA 23452-5765
Phone (757) 395-1600
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220304000436 | VA | Order and Referring Only - Nurse Practitioner | 9739470949 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024173385 | VA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460073600000",
"number": "1225499676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "397 LITTLE NECK RD",
"address_2": "SUITE 100",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234525765",
"telephone_number": "757-395-1600",
"fax_number": "757-961-5938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "397 LITTLE NECK RD",
"address_2": "SUITE 100",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234525765",
"telephone_number": "757-395-1600",
"fax_number": "757-961-5938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIDEON",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-14",
"last_updated": "2016-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "VA",
"license": "0024173385",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.