Individual provider Active NPI

Gabrielle Tiarra Qahhar, NP-C

  • Family Nurse Practitioner
  • Blackstone, VA
National Provider Identifier
1306316377
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024176856 Issued in VA
Practice address
700 Kemper Ave
Blackstone, VA 23824-3061
Phone
(757) 310-3925
Fax
(949) 863-5677
NPI assigned
Dec 3, 2018
Last updated
Dec 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024176856 VA Primary
Primary Care Nurse Practitioner 363LP2300X 0024176856 VA

Addresses

Primary practice location

700 Kemper Ave
Blackstone, VA 23824-3061

Mailing address

700 Kemper Ave
Blackstone, VA 23824-3061
Phone (757) 310-3925

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
I20211129002250 VA Order and Referring Only - Nurse Practitioner 1658614680

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Weight Loss Solutions, LLC CurrentSince Feb 1, 2022 Accepting new patients
Unique Holistic Care LLC PastSince Aug 1, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gabrielle.qahhar@202362935902212.direct.elationemr.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1306316377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 KEMPER AVE",
            "city": "BLACKSTONE",
            "state": "VA",
            "postal_code": "238243061",
            "telephone_number": "757-310-3925",
            "fax_number": "949-863-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 KEMPER AVE",
            "city": "BLACKSTONE",
            "state": "VA",
            "postal_code": "238243061",
            "telephone_number": "757-310-3925",
            "fax_number": "949-863-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QAHHAR",
        "first_name": "GABRIELLE",
        "middle_name": "TIARRA",
        "name_prefix": "Miss",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-03",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024176856",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VA",
            "license": "0024176856",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackstone, VA

Sources for this page

Verify at the official NPI Registry.