Trudy Marcelle Colaw, NP
Individual provider Active NPI Family Nurse Practitioner · Rockingham, VA
NPI 1487809653 · NPPES record last updated Jan 31, 2024
Key facts
- NPI
- 1487809653
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 5006641 (NC)
- Practice address
- 2010 Health Campus Dr
Rockingham, VA 22801-8679 - Phone
- (540) 689-1110
- Fax
- (540) 689-1119
- NPI assigned
- Dec 1, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- South Sound Inpatient Physicians PLLC
Practice addresses (Care Compare)
16251 Sylvester Rd SW
Burien, WA 98166-3017
Phone (206) 244-9970
202 N Division St
Auburn, WA 98001-4939
Phone (253) 833-7711
Hospital & facility affiliations
- Multicare Auburn Medical Center
- Tacoma General Allenmore Hospital
- Multicare Covington Medical Center
- Multicare Good Samaritan Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VA, WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081218000495 | VA | Practitioner - Nurse Practitioner | 3577625961 | Reassigns benefits to 1 organization |
| I20240215002746 | WA | Practitioner - Nurse Practitioner | 3577625961 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9359 | CT | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Sound Inpatient Physicians, PLLC | Current |
Accepting new patients | |
| South Sound Inpatient Physicians PLLC | Nurse Practitioner | Current | Accepting new patients |
| South Sound Inpatient Physicians PLLC | Current |
Accepting new patients | |
| Winchester Neurological Consultants Inc | Current |
Accepting new patients |
Locations
120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040
125A Medical Cir
Winchester, VA 22601
Phone (540) 450-0072
16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970
407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000
Interoperability endpoints
- https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
- tcolaw72489@direct.peacehealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP61520467 | WA | |
| Family Nurse Practitioner | 363LF0000X | 0024168064 | VA | |
| Family Nurse Practitioner | 363LF0000X | 5006641 | NC | Yes |
Addresses
Primary practice location
2010 Health Campus Dr
Rockingham, VA 22801-8679
Mailing address
PO Box 1430
Harrisonburg, VA 22803-1430
Phone (540) 689-1110
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487809653 | Medicaid | VA |
Other names
- Trudy Marcelle Gutshall
Other providers in Rockingham, VA
- Jennifer W Chalker
- Eugene Y Chang
- Elaine A. Clancey
- Chipley Jones Clarke
- Erin Clayton
- Bianca Colmenares
- Eleanor Ann Colmenares
- Stephen Michael Colvin
- Community Birth Group
- Heather Celeste Cook
All providers in Rockingham, VA · Family Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.