Individual provider Active NPI

Lawrence J Nolan, DO

  • Neurocritical Care Physician
  • Norfolk, VA
National Provider Identifier
1629509054
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurocritical Care PhysicianTaxonomy code 2084A2900X
License
0102208047 Issued in VA
Practice address
600 Gresham Dr Ste 8630B
Norfolk, VA 23507-1904
Phone
(757) 388-6115
Fax
(757) 275-9998
NPI assigned
Mar 27, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 63918 NY
Neurocritical Care Physician 2084A2900X 0102208047 VA Primary

Addresses

Primary practice location

600 Gresham Dr Ste 8630B
Norfolk, VA 23507-1904

Mailing address

47 New Scotland Ave
Dept. of Neurology
Albany, NY 12208-3412
Phone (518) 262-3593

Other practice location 1

47 New Scotland Ave
Dept. of Neurology
Albany, NY 12208-3412
Phone (518) 262-3593

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231120001436 VA Practitioner - Critical Care (Intensivists) 5890030654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Lake Erie College of Osteopathic Medicine, Erie, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

600 Gresham Dr
Norfolk, VA 23507-1904
Phone (757) 388-6115

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102208047VAMDNeurocritical Care Physician
63918NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Sep 10, 2023 Accepting new patients

Locations

600 Gresham Dr
Ste 8630
Norfolk, VA 23507
Phone (757) 388-6105

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

600 Gresham Dr
Ste 8630B
Norfolk, VA 23507
Phone (757) 338-6115

Interoperability endpoints

  • Direct secure messaging: lnolan842273@direct.sentara.net

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 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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1629509054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE",
            "address_2": "DEPT. OF NEUROLOGY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-3593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR STE 8630B",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-6115",
            "fax_number": "757-275-9998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 New Scotland Ave",
            "address_2": "Dept. of Neurology",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083412",
            "country_code": "US",
            "telephone_number": "518-262-3593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "LAWRENCE",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-27",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "63918",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "VA",
            "license": "0102208047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.