Racheal Elliott Shaddeau, FNPC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024175611 Issued in VA

Practice address

100 Emancipation Drive
Hampton, VA 23667

Phone

(757) 722-9961

NPI assigned

Aug 26, 2014

Last updated

Mar 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Waterway Emergency Physicians LLC

  • Emergency Medicine Physician
  • Elizabeth City, NC
  • NPI 1487804670
  NPD (past)

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1629478730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 POPLAR BRANCH RD",
            "city": "GRANDY",
            "state": "NC",
            "postal_code": "279399775",
            "telephone_number": "252-619-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EMANCIPATION DRIVE",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "23667",
            "telephone_number": "757-722-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADDEAU",
        "first_name": "RACHEAL",
        "middle_name": "ELLIOTT",
        "name_prefix": "Mrs.",
        "credential": "FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2024-03-12",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "132796",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024175611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyna Setchel
• Winter Lauren Seward-Dixon, FNP-C
• Jennifer Ann Sexton, MD
• Erica-Jandre Seymore, LCSW
• Rachel Elizabeth Sgroi, CRNA, DNP
• Cassandra Wynne Shafer, LCSW
• Mukesh Harilal Shah, M.D.
• Pragna N Shah, MD
• Zarna Shah, PHARM D
• Aftab Dee Shaikh, PA-C

• Family Nurse Practitioner in Hampton, VA
• Providers in Hampton, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.