Emily Wallace Brantley, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024188752 Issued in VA

Practice address

4374 New Town Ave Ste 200
Williamsburg, VA 23188-2865

Phone

(757) 984-6110

NPI assigned

Dec 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Emily Clark Wallace Former name

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

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Home Care Services-Williamsburg Home health agency, Williamsburg, VA, CCN 497748
• Sentara Williamsburg Regional Medical Center Hospital, Williamsburg, VA, CCN 490066
• Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270
  Medicare reassignment Care Compare group NPD

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

• Sentara Enterprises

  • Home Health Agency
  • Williamsburg, VA
  • NPI 1750829164
  Care Compare affiliation
• Sentara Hospitals

  • General Acute Care Hospital
  • Hampton, VA
  • NPI 1336109107
  Care Compare affiliation
• Sentara Hospitals

  • General Acute Care Hospital
  • Williamsburg, VA
  • NPI 1619938149
  Care Compare affiliation

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1366100802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4374 NEW TOWN AVE STE 200",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882865",
            "telephone_number": "757-984-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4374 NEW TOWN AVE STE 200",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882865",
            "telephone_number": "757-984-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANTLEY",
        "first_name": "EMILY",
        "middle_name": "WALLACE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-01",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024188752",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001270316",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "WALLACE",
            "middle_name": "CLARK",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Branch Beyond ABA Consulting and Services
• Marneicia Diane Branch
• Patricia W Branch, CFNP
• Shakia Branch
• Sheila Branson, ACNP-BC
• Suzanne Elizabeth Brassel, PHD
• Joan L Brauckmann, MD
• Kregan Brault, CNM
• Johnston M Brendel, LPC, LMFT
• Suzanne Elaine Brennan, OTR/L

• Family Nurse Practitioner in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.