Individual provider Active NPI

Brook Powell Nelson, PA-C

  • Physician Assistant
  • Martinsville, VA
National Provider Identifier
1366731200
Registry record updated Nov 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110003504 Issued in VA
Practice address
2696 Greensboro Rd
Martinsville, VA 24112-8106
Phone
(276) 638-7205
Fax
(276) 638-3389
NPI assigned
Mar 31, 2011
Last updated
Nov 21, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110003504 VA Primary

Addresses

Primary practice location

2696 Greensboro Rd
Martinsville, VA 24112-8106

Mailing address

2696 Greensboro Rd
Martinsville, VA 24112-8106
Phone (276) 638-7205

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
I20110526000488 VA Practitioner - Physician Assistant 1557548666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians
Oandw EnterprisesGroup PAC ID 6608927298, 216 clinicians

Practice addresses (Care Compare)

100 College Dr
Martinsville, VA 24112-7588
Phone (276) 666-0500

8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845

935 Fairystone Park Hwy
Stanleytown, VA 24168-3014
Phone (888) 724-0268

950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Nov 29, 2017 Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 29, 2017 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients
Dan River Emergency Services LLC Past Accepting new patients
Favero Family Practice Incorporated Past Accepting new patients

Locations

8644 Sudley Rd
#220
Manassas, VA 20110

2696 Greensboro Rd
Martinsville, VA 24112
Phone (276) 638-7205

Interoperability endpoints

  • Direct secure messaging: brook.nelson.1@8042.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1366731200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2696 GREENSBORO RD",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241128106",
            "telephone_number": "276-638-7205",
            "fax_number": "276-638-3389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2696 GREENSBORO RD",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241128106",
            "telephone_number": "276-638-7205",
            "fax_number": "276-638-3389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BROOK",
        "middle_name": "POWELL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsville, VA

Sources for this page

Verify at the official NPI Registry.