Individual provider Active NPI

Sharon L Pemberton, FNP-BC

  • Family Nurse Practitioner
  • Newport News, VA
National Provider Identifier
1407288624
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024171046 Issued in VA
Practice address
101 Philip Roth St Ste 5a
Riverside Gastroenterology Specialists
Newport News, VA 23606-1393
Phone
(757) 599-6333
NPI assigned
Jul 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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 0024171046 VA Primary

Addresses

Primary practice location

101 Philip Roth St Ste 5a
Riverside Gastroenterology Specialists
Newport News, VA 23606-1393

Mailing address

856 J Clyde Morris Blvd Ste a
Riverside Medical Group
Newport News, VA 23601-1318

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
I20130925000354 VA Practitioner - Nurse Practitioner 7113160441 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fall Hill Gastroenterology Associates, LTD. CurrentSince Nov 1, 2015 Accepting new patients
Minuteclinic Diagnostic of Virginia LLC Family CurrentSince Aug 15, 2013 Accepting new patients
Fall Hill Gastroenterology Associates, a Division of Maha, Inc. Past Accepting new patients

Locations

1636 Belle View Blvd
Alexandria, VA 22307
Phone (703) 703-7687

2601 Fall Hill Ave
Fredericksburg, VA 22401
Phone (540) 371-9696

19305 Ruby Dr
Leesburg, VA 20176
Phone (571) 333-5918

Interoperability endpoints

  • Direct secure messaging: spemberton54354@marywashingtonhealthcare.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1407288624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD STE A",
            "address_2": "RIVERSIDE MEDICAL GROUP",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PHILIP ROTH ST STE 5A",
            "address_2": "RIVERSIDE GASTROENTEROLOGY SPECIALISTS",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236061393",
            "telephone_number": "757-599-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMBERTON",
        "first_name": "SHARON",
        "middle_name": "L",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024171046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.