Individual provider Active NPI

Rachael Courtney Mannix, FNP

  • Family Nurse Practitioner
  • Hampton, VA
National Provider Identifier
1356059257
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024184225 Issued in VA
Practice address
200 Eaton St
Hampton, VA 23669-4000
Phone
(757) 726-5000
Fax
(757) 726-5001
NPI assigned
Nov 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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 0024184225 VA Primary

Addresses

Primary practice location

200 Eaton St
Hampton, VA 23669-4000

Mailing address

200 Eaton St
Hampton, VA 23669-4000
Phone (757) 726-5000

Other practice location 1

2994 Churchland Blvd
Chesapeake, VA 23321-5643
Phone (757) 484-0500

Other identifiers 1

IdentifierTypeStateIssuer
363LF000XMedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL eCW

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
I20230321000415 VA Practitioner - Nurse Practitioner 7416321112 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oyster Point Family Practice IncGroup PAC ID 9436137296, 5 clinicians

Practice addresses (Care Compare)

704 Thimble Shoals Blvd
Suite 700
Newport News, VA 23606-4544
Phone (757) 873-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024184225VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Churchland Internal Medicine Associates LTD CurrentSince Oct 29, 2022 Accepting new patients
Sentara Medical Group CurrentSince Mar 11, 2024 Accepting new patients

Locations

2994 Churchland Blvd
Chesapeake, VA 23321
Phone (757) 484-0500

200 Eaton St
Hampton, VA 23669
Phone (757) 726-5000

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

Interoperability endpoints

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

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1356059257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 EATON ST",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236694000",
            "telephone_number": "757-726-5000",
            "fax_number": "757-726-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EATON ST",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236694000",
            "telephone_number": "757-726-5000",
            "fax_number": "757-726-5001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2994 Churchland Blvd",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233215643",
            "country_code": "US",
            "telephone_number": "757-484-0500",
            "fax_number": "757-484-7366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANNIX",
        "first_name": "RACHAEL",
        "middle_name": "COURTNEY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-09",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024184225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363LF000X",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "eCW",
            "affiliation": "N",
            "address_1": "2994 Churchland Blvd",
            "city": "Chesapeake",
            "state": "VA",
            "country_code": "US",
            "postal_code": "233215643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.