Individual provider Active NPI

Vivian Nangoyi Nakawala, NP

  • Nurse Practitioner
  • Haymarket, VA
National Provider Identifier
1609363647
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024175510 Issued in VA
Practice address
15195 Heathcote Blvd Ste 140
Haymarket, VA 20169
Phone
(571) 284-4370
Fax
(571) 284-4387
NPI assigned
Apr 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024175510 VA Primary

Addresses

Primary practice location

15195 Heathcote Blvd Ste 140
Haymarket, VA 20169

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vnakawala298862@direct.novanthealth.org

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
I20180720000150 VA Practitioner - Nurse Practitioner 8628325719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uva Community Health Medical Group LLCGroup PAC ID 4688587967, 339 clinicians

Practice addresses (Care Compare)

10322 Bristow Ctr Dr
Bristow, VA 20136-2201
Phone (571) 261-3270

Hospital & facility affiliations

  • Caregivers Home Health Services, Inc Home health agency, Tysons, VA, CCN 497559
  • Uva Health Haymarket Medical Center Hospital, Haymarket, VA, CCN 490144
  • Uva Health Prince William Medical Center Hospital, Manassas, VA, CCN 490045

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Uva Community Health Medical Group, LLC CurrentSince May 21, 2018 Accepting new patients
Uva Community Health Medical Group, LLC CurrentSince May 21, 2018 Accepting new patients

Locations

10322 Bristow Center Dr
Bristow, VA 20136
Phone (571) 284-4230

4105 Lewis and Clark Dr
Charlottesvle, VA 22911

15195 Heathcote Blvd
Ste 140
Haymarket, VA 20169
Phone (571) 284-4370

8640 Sudley Rd
Ste 203
Manassas, VA 20110
Phone (703) 368-3161

Interoperability endpoints

  • Direct secure messaging: vnakawala298862@direct.novanthealth.org

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 3

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": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1609363647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15195 HEATHCOTE BLVD STE 140",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "20169",
            "telephone_number": "571-284-4370",
            "fax_number": "571-284-4387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAWALA",
        "first_name": "VIVIAN",
        "middle_name": "NANGOYI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024175510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vnakawala298862@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "15195 Heathcote Blvd Ste 140",
            "city": "Haymarket",
            "state": "VA",
            "country_code": "US",
            "postal_code": "20169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Haymarket, VA

Sources for this page

Verify at the official NPI Registry.