Individual provider Active NPI

Amanda Gideon, CPNP

  • Pediatric Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1235509175
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024172959 Issued in VA
Practice address
1250 E Marshall St
Main Hospital 7TH Floor
Richmond, VA 23298-5051
Phone
(804) 439-1236
NPI assigned
Oct 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0024172959 VA Primary

Addresses

Primary practice location

1250 E Marshall St
Main Hospital 7TH Floor
Richmond, VA 23298-5051

Mailing address

1250 E Marshall St
Main Hospital 7TH Floor
Richmond, VA 23298-5051

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
I20250624001786 VA Practitioner - Nurse Practitioner 4587176797 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024172959VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince Mar 28, 2025 Accepting new patients

Locations

1001 E Leigh St
Richmond, VA 23298
Phone (804) 628-7497

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

1250 E Marshall St
Fl 7
Richmond, VA 23298
Phone (804) 828-4987

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1235509175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E MARSHALL ST",
            "address_2": "MAIN HOSPITAL 7TH FLOOR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E MARSHALL ST",
            "address_2": "MAIN HOSPITAL 7TH FLOOR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985051",
            "telephone_number": "804-439-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIDEON",
        "first_name": "AMANDA",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-05",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024172959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.