Individual provider Active NPI

Andrea S. Yesalis, NP, PHD, CCD

  • Nurse Practitioner
  • Lynchburg, VA
National Provider Identifier
1407009251
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024169954 Issued in VA
Practice address
2405 Atherholt Rd
Lynchburg, VA 24501-2184
Phone
(434) 485-8500
Fax
(434) 485-8599
NPI assigned
Oct 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001236204 VA
Nurse Practitioner 363L00000X RN285740L PA
Nurse Practitioner 363L00000X SP010069 PA
Nurse Practitioner 363L00000X 0024169954 VA Primary

Addresses

Primary practice location

2405 Atherholt Rd
Lynchburg, VA 24501-2184

Mailing address

2405 Atherholt Rd
Lynchburg, VA 24501-2184
Phone (434) 485-8500

Other identifiers 1

IdentifierTypeStateIssuer
1407009251MedicaidVA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tdavis6905@direct.orthovirginia.com
Direct Messaging Address ayesalis6153@direct.orthovirginia.com Other

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
I20120426000478 VA Practitioner - Nurse Practitioner 8921161423 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0001236204VAMDRegistered Nurse
RN285740LPAMDNurse Practitioner
SP010069PAMDNurse Practitioner
0024169954VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orthovirginia Inc Nurse Practitioner Current Accepting new patients
Orthovirginia, Inc CurrentSince Jan 1, 2016 Accepting new patients
Orthovirginia, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

2405 Atherholt Rd
Lynchburg, VA 24501
Phone (434) 485-8500

8200 Meadowbridge Rd
Ste 200
Mechanicsville, VA 23116
Phone (804) 560-5595

1115 Boulders Pkwy
Ste 200
North Chesterfield, VA 23225
Phone (804) 327-9242

Interoperability endpoints

  • Direct secure messaging: ayesalis6153@direct.orthovirginia.com
  • Direct secure messaging: tdavis6905@direct.orthovirginia.com

Organizations & group practices 4

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": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1407009251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 ATHERHOLT RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012184",
            "telephone_number": "434-485-8500",
            "fax_number": "434-485-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 ATHERHOLT RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012184",
            "telephone_number": "434-485-8500",
            "fax_number": "434-485-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YESALIS",
        "first_name": "ANDREA",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "NP, PHD, CCD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-24",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001236204",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "RN285740L",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP010069",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024169954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407009251",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tdavis6905@direct.orthovirginia.com",
            "affiliation": "N",
            "endpointDescription": "Thorp Davis direct address",
            "address_1": "2405 Atherholt Rd",
            "city": "Lynchburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "245012184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ayesalis6153@direct.orthovirginia.com",
            "affiliation": "N",
            "endpointDescription": "Dr. Yesalis direct address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "secure messaging",
            "address_1": "2405 Atherholt Rd",
            "city": "Lynchburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "245012184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.