Individual provider Active NPI

Virginia L. Velazquez, NP

  • Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1609952670
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209006069 Issued in IL
Practice address
1235 N Mulford Rd
Suite 222
Rockford, IL 61107-3879
Phone
(815) 397-8400
Fax
(815) 229-0050
NPI assigned
Oct 31, 2006
Last updated
Jul 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209-006069 IL
Nurse Practitioner 363L00000X 209006069 IL Primary
Registered Nurse 163W00000X 041263753 IL

Addresses

Primary practice location

1235 N Mulford Rd
Suite 222
Rockford, IL 61107-3879

Mailing address

1235 N Mulford Rd
Suite 222
Rockford, IL 61107-3879
Phone (815) 397-8400

Other identifiers 3

IdentifierTypeStateIssuer
820800061OtherILMEDICARE PTAN (INDIVIDUAL)
209006069OtherILLICENSE
820800OtherILMEDICARE PTAN (GROUP)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20070228000533 IL Practitioner - Nurse Practitioner 1759483340 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians

Practice addresses (Care Compare)

2400 N Rockton Ave
Rockford, IL 61103-3655
Phone (815) 971-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041263753ILMDRegistered Nurse
209-006069ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Jan 30, 2023 Accepting new patients
RMH Pathologists, LTD Current Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Greater Elgin Emergency Specialists LTD Past Accepting new patients
Dupage Health Services, Inc. PastSince Sep 19, 2012 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

6830 Villagreen Vw
Rockford, IL 61107
Phone (815) 282-1339

698 Featherstone Rd
Rockford, IL 61107
Phone (815) 398-3277

698 Featherstone Rd
Ste 25
Rockford, IL 61107
Phone (815) 339-9440

8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066

Interoperability endpoints

  • Direct secure messaging: vvelazquez100156@direct.mhemail.org

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1609952670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 N MULFORD RD",
            "address_2": "SUITE 222",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073879",
            "telephone_number": "815-397-8400",
            "fax_number": "815-229-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 N MULFORD RD",
            "address_2": "SUITE 222",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073879",
            "telephone_number": "815-397-8400",
            "fax_number": "815-229-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "VIRGINIA",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-006069",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209006069",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041263753",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "820800061",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "209006069",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "820800",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.