Individual provider Active NPI

Cynthia N Trent, CPNP, AE-C

  • Pediatric Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1609870625
Registry record updated Sep 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024127248 Issued in VA
Practice address
1212 Lake James Dr
Suite C
Virginia Beach, VA 23464-6779
Phone
(757) 523-4589
Fax
(757) 523-8920
NPI assigned
Jun 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0024127248 VA Primary

Addresses

Primary practice location

1212 Lake James Dr
Suite C
Virginia Beach, VA 23464-6779

Mailing address

1212 Lake James Dr
Suite C
Virginia Beach, VA 23464-6779
Phone (757) 523-4589

Other identifiers 1

IdentifierTypeStateIssuer
7793049MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024127248VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrics of Kempsville, P.C. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cynthia.trent.1@29909.direct.athenahealth.com

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": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1609870625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 LAKE JAMES DR",
            "address_2": "SUITE C",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234646779",
            "telephone_number": "757-523-4589",
            "fax_number": "757-523-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 LAKE JAMES DR",
            "address_2": "SUITE C",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234646779",
            "telephone_number": "757-523-4589",
            "fax_number": "757-523-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRENT",
        "first_name": "CYNTHIA",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "CPNP, AE-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-08",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024127248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7793049",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.