Individual provider Active NPI

Elizabeth A Nordlie, FNP-BC

  • Family Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1508697376
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024190783 Issued in VA
Practice address
5801 Bremo Rd
Richmond, VA 23226-1907
Phone
(804) 285-2011
NPI assigned
Aug 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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 0024190783 VA Primary

Addresses

Primary practice location

5801 Bremo Rd
Richmond, VA 23226-1907

Mailing address

5801 Bremo Rd
Richmond, VA 23226-1907
Phone (804) 285-2011

Other practice location 1

5875 Bremo Rd Ste 311
Richmond, VA 23226-1934
Phone (804) 287-7574

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
I20241224001271 VA Practitioner - Nurse Practitioner 2769919141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Medical Group Richmond Specialty Care LLCGroup PAC ID 8022440056, 350 clinicians

Practice addresses (Care Compare)

1510 N 28TH St
Richmond, VA 23223-5311

5801 Bremo Rd
Richmond, VA 23226-1907
Phone (804) 764-6000

Hospital & facility affiliations

  • Bon Secours St Marys Hospital Hospital, Richmond, VA, CCN 490059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024190783VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Dec 1, 2024 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

5875 Bremo Rd
Ste 311
Richmond, VA 23226
Phone (804) 287-3550

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1508697376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 BREMO RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261907",
            "telephone_number": "804-285-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 BREMO RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261907",
            "telephone_number": "804-285-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5875 Bremo Rd Ste 311",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232261934",
            "country_code": "US",
            "telephone_number": "804-287-7574",
            "fax_number": "804-287-7949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORDLIE",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024190783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.