Active NPI
Nancy E Graddy, LCSW
- Clinical Social Worker
- Portsmouth, VA
National Provider Identifier
1295722304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904000261
- Practice address
- 3300 Academy Ave
Academy Crossing Medical Plaza
Portsmouth, VA 23703-3205 - Phone
- (757) 483-6404
- Fax
- (757) 483-0737
- NPI assigned
- Oct 4, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904000261 | VA | Primary |
Addresses
Primary practice location
3300 Academy Ave
Academy Crossing Medical Plaza
Portsmouth, VA 23703-3205
Mailing address
3300 Academy Ave
Academy Crossing Medical Plaza
Portsmouth, VA 23703-3205
Phone (757) 483-6404
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38822 | Other | VA | ANTHEM |
| 086099M | Other | VA | SENTARA |
| 010081866 | Medicaid | VA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904000261 | VA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Physician Services Inc | Clinical | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374624000000",
"number": "1295722304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 ACADEMY AVE",
"address_2": "ACADEMY CROSSING MEDICAL PLAZA",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237033205",
"telephone_number": "757-483-6404",
"fax_number": "757-483-0737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 ACADEMY AVE",
"address_2": "ACADEMY CROSSING MEDICAL PLAZA",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237033205",
"telephone_number": "757-483-6404",
"fax_number": "757-483-0737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRADDY",
"first_name": "NANCY",
"middle_name": "E",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-04",
"last_updated": "2013-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904000261",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "38822",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA",
"identifier": "086099M",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010081866",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portsmouth, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.