Individual provider Active NPI

Verlecia Self

  • Family Nurse Practitioner
  • Chester, VA
National Provider Identifier
1255885638
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016007862 Issued in VA
Practice address
221 E Hundred Rd
Chester, VA 23836-2613
Phone
(866) 389-2727
NPI assigned
Aug 15, 2016
Last updated
Aug 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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 2016007862 VA Primary

Addresses

Primary practice location

221 E Hundred Rd
Chester, VA 23836-2613

Mailing address

11344 Chester Garden Cir
Chester, VA 23831-1795
Phone (225) 747-0090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161114000021 DC Practitioner - Nurse Practitioner 9931488020 Reassigns benefits to 1 organization
I20161213001390 VA Practitioner - Nurse Practitioner 9931488020 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016007862VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Virginia LLC Family CurrentSince Oct 3, 2016 Accepting new patients
Hospitalist Medicine Physicians of Fredericksburg, LLC CurrentSince Mar 1, 2018 Accepting new patients
Lake Spring Physician Services, LLC CurrentSince Jul 11, 2018 Accepting new patients
Apogee Medical Group Virginia, PC CurrentSince Nov 1, 2016 Accepting new patients
Kingsford Physician Services, LLC CurrentSince Jul 11, 2018 Accepting new patients

Locations

1636 Belle View Blvd
Alexandria, VA 22307
Phone (703) 703-7687

221 E Hundred Rd
Chester, VA 23836
Phone (804) 530-1172

19305 Ruby Dr
Leesburg, VA 20176
Phone (571) 333-5918

320 Hospital Dr
Martinsville, VA 24112
Phone (276) 666-7200

8260 Atlee Rd
Mechanicsvlle, VA 23116
Phone (804) 264-6000

13710 St Francis Blvd
Midlothian, VA 23114
Phone (804) 594-7300

2400 Lee Hwy N
Pulaski, VA 24301
Phone (540) 994-8100

1500 N 28th St
Richmond, VA 23223
Phone (804) 225-1700

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1255885638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11344 CHESTER GARDEN CIR",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238311795",
            "telephone_number": "225-747-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E HUNDRED RD",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238362613",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "VERLECIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "2016007862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, VA

Sources for this page

Verify at the official NPI Registry.