Individual provider Active NPI

Jerica Leigh Carmichael, RBT

  • Technician
  • Virginia Beach, VA
National Provider Identifier
1417540790
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
TechnicianTaxonomy code 374700000X
License
RBT-21-156114 Issued in VA
Practice address
293 Independence Blvd Ste 400
Virginia Beach, VA 23462-5461
Phone
(757) 645-7732
NPI assigned
Feb 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Technician 374700000X RBT-21-156114 VA Primary

Addresses

Primary practice location

293 Independence Blvd Ste 400
Virginia Beach, VA 23462-5461

Mailing address

3503 London Company Way Ste 400
Williamsburg, VA 23185-7932
Phone (757) 645-7732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RBT-21-156114VAMDTechnician

NPI Registry JSON

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1417540790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3503 LONDON COMPANY WAY STE 400",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231857932",
            "telephone_number": "757-645-7732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 INDEPENDENCE BLVD STE 400",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625461",
            "telephone_number": "757-645-7732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMICHAEL",
        "first_name": "JERICA",
        "middle_name": "LEIGH",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "VA",
            "license": "RBT-21-156114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.