Individual provider Active NPI

Nicole Michelle Marshall, FNP

  • Family Nurse Practitioner
  • Gloucester, VA
National Provider Identifier
1295497709
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024182942 Issued in VA
Practice address
6031 Industrial Dr
Gloucester, VA 23061-3767
Phone
(804) 210-1368
Fax
(804) 684-3691
NPI assigned
Oct 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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 0024182942 VA Primary

Addresses

Primary practice location

6031 Industrial Dr
Gloucester, VA 23061-3767

Mailing address

6031 Industrial Dr
Gloucester, VA 23061-3767
Phone (804) 210-1368

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
I20220526000593 VA Practitioner - Nurse Practitioner 7810375268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
George Washington University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidewater Physicians Multispecialty Group, PCGroup PAC ID 2860398526, 259 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

11848 Rock Landing Dr
Newport News, VA 23606-4425

2600 Compass Rd
Glenview, IL 60026-8001

704 Thimble Shoals Blvd
300A
Newport News, VA 23606-4554
Phone (757) 595-4300

860 Omni Blvd
Newport News, VA 23606-4430

Hospital & facility affiliations

  • Medi Home Health Agency Home health agency, Chesapeake, VA, CCN 497580
  • Enhabit Home Health (VA Beach) Home health agency, Virginia Beach, VA, CCN 497644
  • Commonwealth Home Care Home health agency, Portsmouth, VA, CCN 497775
  • Mary Immaculate Hospital Hospital, Newport News, VA, CCN 490041
  • Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
  • Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093
  • Bon Secours Maryview Medical Center Hospital, Portsmouth, VA, CCN 490017

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Oct 16, 2023 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Oct 16, 2023 Accepting new patients

Locations

704 Thimble Shoals Blvd
#30
Newport News, VA 23606
Phone (757) 595-4300

827 Diligence Dr
Ste 100
Newport News, VA 23606

860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138

11848 Rock Landing Dr
Ste 401
Newport News, VA 23606
Phone (757) 243-8550

11848 Rock Landing Dr
Ste 402
Newport News, VA 23606
Phone (757) 234-8770

860 Omni Blvd
Ste 128
Newport News, VA 23606

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 3

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1295497709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6031 INDUSTRIAL DR",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230613767",
            "telephone_number": "804-210-1368",
            "fax_number": "804-684-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6031 INDUSTRIAL DR",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230613767",
            "telephone_number": "804-210-1368",
            "fax_number": "804-684-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "NICOLE",
        "middle_name": "MICHELLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024182942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, VA

Sources for this page

Verify at the official NPI Registry.