Individual provider Active NPI

Stephanie Williams Hatch, AGACNP-BC

  • Gerontology Nurse Practitioner
  • Suffolk, VA
National Provider Identifier
1285240648
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0024180183 Issued in VA
Practice address
3920A Bridge Rd Ste 204
Suffolk, VA 23435-1117
Phone
(757) 983-0351
Fax
(757) 510-9218
NPI assigned
Sep 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0024180183 VA
Gerontology Nurse Practitioner 363LG0600X 0024180183 VA Primary

Addresses

Primary practice location

3920A Bridge Rd Ste 204
Suffolk, VA 23435-1117

Mailing address

3920A Bridge Rd Ste 204
Suffolk, VA 23435-1117
Phone (757) 983-0351

Other practice location 1

304 Homestead Rd
Franklin, VA 23851-1345
Phone (757) 576-3067

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
I20201217000878 VA Practitioner - Nurse Practitioner 6507278462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

3920 A Bridge Rd
Suite 204
Suffolk, VA 23435-1117
Phone (757) 983-0351

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Feb 1, 2021 Accepting new patients

Locations

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

3920A Bridge Rd
Ste 204
Suffolk, VA 23435
Phone (757) 983-0351

Interoperability endpoints

  • Direct secure messaging: shatch450997@direct.sentara.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1285240648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920A BRIDGE RD STE 204",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351117",
            "telephone_number": "757-983-0351",
            "fax_number": "757-510-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920A BRIDGE RD STE 204",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351117",
            "telephone_number": "757-983-0351",
            "fax_number": "757-510-9218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "304 Homestead Rd",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "VA",
            "postal_code": "238511345",
            "country_code": "US",
            "telephone_number": "757-576-3067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATCH",
        "first_name": "STEPHANIE",
        "middle_name": "WILLIAMS",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024180183",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024180183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.