Individual provider Active NPI

Jennifer Rothberg, MSN, RNC, NNP-BC

  • Neonatal Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1235644360
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
0024175729 Issued in VA
Practice address
5801 Bremo Rd
Richmond, VA 23226-1907
Phone
(804) 285-2011
NPI assigned
Dec 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X 0001255692 VA
Neonatal Nurse Practitioner 363LN0000X 0024175729 VA Primary

Addresses

Primary practice location

5801 Bremo Rd
Richmond, VA 23226-1907

Mailing address

3527 Covered Bridge LN
Woodbridge, VA 22192-6412
Phone (601) 473-6270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20220609003091 DC Practitioner - Nurse Practitioner 3779831730 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0001255692VAMDNeonatal Intensive Care Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital CurrentSince May 17, 2022 Accepting new patients
Children'S Hospital CurrentSince May 17, 2022 Accepting new patients
Children'S Hospital Current Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

Organizations & group practices 3

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": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1235644360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3527 COVERED BRIDGE LN",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221926412",
            "telephone_number": "601-473-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 BREMO RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261907",
            "telephone_number": "804-285-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHBERG",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "MSN, RNC, NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "VA",
            "license": "0001255692",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "VA",
            "license": "0024175729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.