Individual provider Active NPI

Nina Latasha Jernigan, FNP

  • Family Nurse Practitioner
  • Hampton, VA
National Provider Identifier
1245523638
Registry record updated Sep 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024169403 Issued in VA
Practice address
1320 Lasalle Ave
Hampton, VA 23669-3801
Phone
(757) 727-1820
NPI assigned
May 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2015

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 0024169403 VA Primary

Addresses

Primary practice location

1320 Lasalle Ave
Hampton, VA 23669-3801

Mailing address

924 Shore Dr
Newport News, VA 23607-6435
Phone (757) 503-3069

Other names 1

  • Nina Stokes Former name

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
I20140225000903 VA Practitioner - Nurse Practitioner 6901036607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

95 Magnolia Dr
Newport News, VA 23605-1135
Phone (757) 869-5075

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Health Care, LLC CurrentSince Dec 16, 2015 Accepting new patients
Sandhya Rajasekhara PastSince Jun 21, 2020 Accepting new patients

Organizations & group practices 2

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": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1245523638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 SHORE DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236076435",
            "telephone_number": "757-503-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 LASALLE AVE",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236693801",
            "telephone_number": "757-727-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERNIGAN",
        "first_name": "NINA",
        "middle_name": "LATASHA",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-18",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024169403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NINA",
            "last_name": "STOKES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.