Individual provider Active NPI

Stephen Paul Boychuck, RN, MSN, FNP,C

  • Family Nurse Practitioner
  • Fort Lee, VA
National Provider Identifier
1275524860
Registry record updated Apr 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024097373 Issued in VA
Practice address
700 24TH St
Attn: Credentials Office
Fort Lee, VA 23801-1716
Phone
(804) 734-9295
Fax
(804) 734-9016
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2011

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 0024097373 VA Primary

Addresses

Primary practice location

700 24TH St
Attn: Credentials Office
Fort Lee, VA 23801-1716

Mailing address

700 24TH St
Attn: Credentials Office
Fort Lee, VA 23801-1716
Phone (804) 734-9295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0024097373VAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303776000000",
    "number": "1275524860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 24TH ST",
            "address_2": "ATTN: CREDENTIALS OFFICE",
            "city": "FORT LEE",
            "state": "VA",
            "postal_code": "238011716",
            "telephone_number": "804-734-9295",
            "fax_number": "804-734-9016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 24TH ST",
            "address_2": "ATTN: CREDENTIALS OFFICE",
            "city": "FORT LEE",
            "state": "VA",
            "postal_code": "238011716",
            "telephone_number": "804-734-9295",
            "fax_number": "804-734-9016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYCHUCK",
        "first_name": "STEPHEN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "RN, MSN, FNP,C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2011-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024097373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.