Individual provider Active NPI

Gilda Niknezhad, NP

  • Family Nurse Practitioner
  • Norfolk, VA
National Provider Identifier
1245330190
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024166613 Issued in VA
Practice address
160 Kingsley LN
Suite 106
Norfolk, VA 23505-4600
Phone
(757) 889-5735
Fax
(757) 889-5742
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024166613 VA Primary

Addresses

Primary practice location

160 Kingsley LN
Suite 106
Norfolk, VA 23505-4600

Mailing address

110 Kingsley LN
Suite 106
Norfolk, VA 23505-4614
Phone (757) 889-5735

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
I20070320000233 VA Practitioner - Nurse Practitioner 0941303507 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SE Virginia Value Based Care LLCGroup PAC ID 6103288170, 160 clinicians
Mid-Atlantic Post Acute and Long Term Care PLLCGroup PAC ID 0648530782, 142 clinicians

Practice addresses (Care Compare)

Norfolk, VA 23502
Phone (757) 354-2885

6160 Kempsville Cir
Suite 325a
Norfolk, VA 23502-3933
Phone (757) 354-2885

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024166613VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SE Virginia Value Based Care, LLC CurrentSince Aug 1, 2023 Accepting new patients
Mid-Atlantic Post Acute & Long Term Care PLLC Family CurrentSince Jan 17, 2018 Accepting new patients
Apm Spine and Sports Physicians, P.C. Past Accepting new patients

Locations

1017 George Washington Hwy N
Chesapeake, VA 23323
Phone (757) 485-5000

110 Kingsley Ln
Ste 106
Norfolk, VA 23505
Phone (757) 354-2885

6160 Kempsville Cir
Ste 325A
Norfolk, VA 23502
Phone (757) 354-2885

1948 Landstown Centre Way
Virginia Beach, VA 23456
Phone (751) 821-7500

1148 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 481-3321

1004 Independence Blvd
Virginia Beach, VA 23455
Phone (757) 464-4058

440 N Lynnhaven Rd
Virginia Beach, VA 23452
Phone (757) 231-5049

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245330190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 KINGSLEY LN",
            "address_2": "SUITE 106",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054614",
            "telephone_number": "757-889-5735",
            "fax_number": "757-889-5742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 KINGSLEY LN",
            "address_2": "SUITE 106",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054600",
            "telephone_number": "757-889-5735",
            "fax_number": "757-889-5742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKNEZHAD",
        "first_name": "GILDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024166613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.