Angela Nichole Whiteside

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110007302 Issued in VA

Practice address

1306 Fairways Lookout Apt a
Chesapeake, VA 23320-1104

Phone

(410) 688-7513

NPI assigned

Feb 16, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Eastern Virginia Medical School, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SE Virginia Value Based Care LLCGroup PAC ID 6103288170, 160 clinicians

Mid Atlantic Long Term Specialty Care LLCGroup PAC ID 8921427162, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mid Atlantic Long Term Specialty Care LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Norfolk, VA
  • NPI 1851909998
  Medicare reassignment Care Compare group
• SE Virginia Value Based Care, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Norfolk, VA
  • NPI 1225720501
  Medicare reassignment Care Compare group
• Tidewater Psychotherapy Services

  • Social Worker
  • Virginia Beach, VA
  • NPI 1700830742
  Medicare reassignment
• Tidewater Psychotherapy Services

  • Addiction (Substance Use Disorder) Counselor
  • Virginia Beach, VA
  • NPI 1164536496
  NPD (past)

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

{
    "created_epoch": "1581811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1316570518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 FAIRWAYS LOOKOUT APT A",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233201104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 FAIRWAYS LOOKOUT APT A",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233201104",
            "telephone_number": "410-688-7513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITESIDE",
        "first_name": "ANGELA",
        "middle_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-16",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110007302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelly Lynn White, DPT
• Stephanie E White, BSN, RN
• Minnie Whitehead, LCSW
• Sue Whitehurst-Doss, FNP
• Leland D Whitelock, M.D.
• Paul F Whiteside, MD
• Mary Elizabeth Whitley
• Paula Whitley
• Whitley'S Home Health Care LLC
• Tara Whitlow

• Physician Assistant in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.