Individual provider Active NPI

Taneisha Patrice Gayles, FNP

  • Family Nurse Practitioner
  • Newport News, VA
National Provider Identifier
1396512950
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024188735 Issued in VA
Practice address
702 City Center Blvd Ste C
Newport News, VA 23606-3096
Phone
(757) 679-6058
NPI assigned
Dec 5, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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 0024188735 VA Primary

Addresses

Primary practice location

702 City Center Blvd Ste C
Newport News, VA 23606-3096

Mailing address

20 Gold Leaf PL
Hampton, VA 23666-6807
Phone (757) 602-5551

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
I20240119003166 VA Practitioner - Nurse Practitioner 4587016068 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024188735VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DPC Jewett LLC CurrentSince Dec 10, 2023 Accepting new patients
Pai Participant 1 LLC CurrentSince Aug 25, 2024 Accepting new patients
SE Virginia Value Based Care, LLC CurrentSince Jan 3, 2024 Accepting new patients
Mid-Atlantic Post Acute & Long Term Care PLLC Family CurrentSince Jan 15, 2024 Accepting new patients
Universal Health Corporation CurrentSince Jul 27, 2024 Accepting new patients

Locations

1475 Virginia Ave
Harrisonburg, VA 22802
Phone (540) 564-3400

702 City Center Blvd
Ste C
Newport News, VA 23606
Phone (757) 679-6058

6160 Kempsville Cir
Ste 325A
Norfolk, VA 23502
Phone (757) 354-2885

1945 Roanoke Blvd
Salem, VA 24153
Phone (540) 345-3094

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1396512950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GOLD LEAF PL",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666807",
            "telephone_number": "757-602-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 CITY CENTER BLVD STE C",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063096",
            "telephone_number": "757-679-6058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYLES",
        "first_name": "TANEISHA",
        "middle_name": "PATRICE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024188735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.