Active NPI
Edwin Edison Gatewood, M.D.
- Psychiatry Physician
- Norfolk, VA
National Provider Identifier
1265406144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0101054731
- Practice address
- 825 Fairfax Ave
Suite 710
Norfolk, VA 23507-1914 - Phone
- (757) 446-5888
- Fax
- (757) 446-5918
- NPI assigned
- Feb 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0101054731 | VA | Primary |
Addresses
Primary practice location
825 Fairfax Ave
Suite 710
Norfolk, VA 23507-1914
Mailing address
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone (757) 953-5269
Other identifiers 17
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 283237 | Other | VA | ANTHEM |
| -006 | Other | VA | TRICARE/CHAMPUS |
| 007110600 | Medicaid | VA | |
| PAR | Other | VA | FIRST HEALTH COMMERCIAL |
| 0520K | Other | NC | BC/BS |
| 155139 | Other | MHN | |
| 209852 | Other | MAGELLAN | |
| 263582 | Other | VA | UHC/MAMSI |
| 690520K | Medicaid | NC | |
| 89030 | Other | VA | SENTARA / OPTIMA |
| PAR | Other | VA | AETNA |
| PAR | Other | VA | VIRGINIA HEALTH NETWORK |
| 120503 | Other | VALUE OPTIONS | |
| PAR | Other | VA | CIGNA BEHAVIORAL HEALTH |
| PAR | Other | VA | MULTIPLAN |
| PAR | Other | VA | CORVEL/CORCARE |
| PAR | Other | VA | USA MANAGED CARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130603000642 | VA | Order and Referring Only - Psychiatry | 9638210677 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of Chesapeake | Past | Accepting new patients |
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.
-
dba City of Chesapeake Emergency Medical Services
- Ambulance
- Chesapeake, VA
- NPI 1659385938
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1265406144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 JOHN PAUL JONES CIR",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237082111",
"telephone_number": "757-953-5269",
"fax_number": "757-953-6907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 FAIRFAX AVE",
"address_2": "SUITE 710",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235071914",
"telephone_number": "757-446-5888",
"fax_number": "757-446-5918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GATEWOOD",
"first_name": "EDWIN",
"middle_name": "EDISON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-15",
"last_updated": "2020-10-22",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0101054731",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "283237",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE/CHAMPUS",
"identifier": "-006",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007110600",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH COMMERCIAL",
"identifier": "PAR",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "0520K",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN",
"identifier": "155139",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "209852",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC/MAMSI",
"identifier": "263582",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "690520K",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA / OPTIMA",
"identifier": "89030",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "PAR",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA HEALTH NETWORK",
"identifier": "PAR",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "120503",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL HEALTH",
"identifier": "PAR",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "PAR",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CORVEL/CORCARE",
"identifier": "PAR",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "USA MANAGED CARE",
"identifier": "PAR",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.