Individual provider Active NPI

W Lawrence Daniels, PHD, RN, CPNP

  • Pediatric Nurse Practitioner
  • Chesapeake, VA
National Provider Identifier
1578803078
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024128887 Issued in VA
Practice address
115 Bruton CT Ste C
Chesapeake, VA 23322-4377
Phone
(757) 410-2644
NPI assigned
Feb 20, 2013
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0024128887 VA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024128887 VA
Registered Nurse 163W00000X 0001128887 VA

Addresses

Primary practice location

115 Bruton CT Ste C
Chesapeake, VA 23322-4377

Mailing address

4583 Hialeah Dr
Virginia Beach, VA 23464-3220
Phone (757) 681-4621

Other practice location 1

5604 Virginia Beach Blvd
Virginia Beach, VA 23462-5631
Phone (757) 455-5000

Other identifiers 1

IdentifierTypeStateIssuer
010099536MedicaidVA

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
I20191024002628 VA Practitioner - Nurse Practitioner 7517299571

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner, Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001128887VAMDRegistered Nurse
0024128887VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The James Barry Robinson Center Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1578803078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4583 HIALEAH DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234643220",
            "telephone_number": "757-681-4621",
            "fax_number": "757-455-5238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BRUTON CT STE C",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233224377",
            "telephone_number": "757-410-2644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5604 Virginia Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234625631",
            "country_code": "US",
            "telephone_number": "757-455-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "W LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "PHD, RN, CPNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-20",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024128887",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024128887",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001128887",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010099536",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.