Individual provider Active NPI

Octavia Siegel-Hawley Schlueter, NP

  • Pediatric Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1437411907
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0017140020 Issued in VA
Practice address
508 Libbie Ave Ste 200
Richmond, VA 23226-2618
Phone
(434) 202-4080
Fax
(844) 705-0170
NPI assigned
Jun 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0017140020 VA Primary

Addresses

Primary practice location

508 Libbie Ave Ste 200
Richmond, VA 23226-2618

Mailing address

9407 Cumberland Rd
New Kent, VA 23124-2029
Phone (804) 966-2242

Other names 1

  • Octavia Kendall Siegel Hawley Former name

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0017140020VAMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1437411907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9407 CUMBERLAND RD",
            "city": "NEW KENT",
            "state": "VA",
            "postal_code": "231242029",
            "telephone_number": "804-966-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 LIBBIE AVE STE 200",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262618",
            "telephone_number": "434-202-4080",
            "fax_number": "844-705-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLUETER",
        "first_name": "OCTAVIA",
        "middle_name": "SIEGEL-HAWLEY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0017140020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OCTAVIA",
            "last_name": "SIEGEL HAWLEY",
            "middle_name": "KENDALL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.