Active NPI
Susan Anne Nichols, MD
- Infectious Disease Physician
- Norfolk, VA
National Provider Identifier
1558529180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 0101250348
- Practice address
- 850 Kempsville Rd Ste 100F
Norfolk, VA 23502-3920 - Phone
- (757) 261-5910
- Fax
- (757) 275-9940
- NPI assigned
- May 30, 2008
- Last updated
- Aug 11, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 0101250348 | VA | |
| Infectious Disease Physician | 207RI0200X | 149301 | NC | |
| Infectious Disease Physician | 207RI0200X | 0101250348 | VA | Primary |
Addresses
Primary practice location
850 Kempsville Rd Ste 100F
Norfolk, VA 23502-3920
Mailing address
850 Kempsville Rd Ste 100F
Norfolk, VA 23502-3920
Phone (757) 261-5910
Other practice location 1
2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178
Phone (757) 388-3198
Other practice location 2
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-4268
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Infectious Disease
- Education
- Wright State University Boonshoft School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
850 Kempsville Rd
Suite 100F
Norfolk, VA 23502-3920
Phone (757) 261-5910
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101250348 | VA | MD | Internal Medicine Physician |
| 149301 | NC | MD | Infectious Disease Physician |
Interoperability endpoints
- stober57832@direct.sentara.net
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Norfolk, VA
- NPI 1265485270
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Sentara Norfolk General Hospital
- General Acute Care Hospital
- Norfolk, VA
- NPI 1437119310
-
dba Sentara Virginia Beach General Hospital
- General Acute Care Hospital
- Virginia Beach, VA
- NPI 1629038336
-
- General Acute Care Hospital
- Virginia Beach, VA
- NPI 1528028396
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597104000000",
"number": "1558529180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 KEMPSVILLE RD STE 100F",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235023920",
"telephone_number": "757-261-5910",
"fax_number": "757-275-9940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 KEMPSVILLE RD STE 100F",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235023920",
"telephone_number": "757-261-5910",
"fax_number": "757-275-9940"
}
],
"practiceLocations": [
{
"address_1": "2025 Glenn Mitchell Dr",
"address_purpose": "LOCATION",
"city": "Virginia Beach",
"state": "VA",
"postal_code": "234560178",
"country_code": "US",
"telephone_number": "757-388-3198",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2100 Stantonsburg Rd",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "NC",
"postal_code": "278342818",
"country_code": "US",
"telephone_number": "252-847-4268",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NICHOLS",
"first_name": "SUSAN",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-30",
"last_updated": "2020-08-11",
"certification_date": "2020-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101250348",
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "NC",
"license": "149301",
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "VA",
"license": "0101250348",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.