Individual provider Active NPI

Lynda Carol Marroletti, AGPCNP-C

  • Gerontology Nurse Practitioner
  • Portsmouth, VA
National Provider Identifier
1629543129
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0024177066 Issued in VA
Practice address
2929 London Blvd
Portsmouth, VA 23707-3405
Phone
(757) 861-9010
NPI assigned
Oct 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X C-APN.0101222-C-NP CO
Gerontology Nurse Practitioner 363LG0600X 0024177066 VA Primary

Addresses

Primary practice location

2929 London Blvd
Portsmouth, VA 23707-3405

Mailing address

2929 London Blvd
Portsmouth, VA 23707-3405
Phone (757) 861-9010

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
I20190312002161 VA Practitioner - Nurse Practitioner 0244396703 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C-APN.0101222-C-NPCOMDNurse Practitioner
0024177066VAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
M Medical Group, Inc. CurrentSince Mar 2, 2023 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC Nurse Practitioner CurrentSince Jan 1, 2020 Accepting new patients
M Medical Group, Inc. CurrentSince Mar 2, 2023 Accepting new patients

Locations

688 Kingsborough Sq
Chesapeake, VA 23320
Phone (757) 547-9111

2 Bernardine Dr
Newport News, VA 23602
Phone (757) 886-6000

12720 McManus Blvd
Ste 305
Newport News, VA 23602
Phone (757) 947-3170

150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944

155 Kingsley Ln
Ste 150
Norfolk, VA 23505
Phone (757) 278-2350

3636 High St
Portsmouth, VA 23707
Phone (757) 398-2200

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

828 Healthy Way
Ste 220
Virginia Beach, VA 23462
Phone (757) 305-1797

1801 Camelot Dr
Virginia Beach, VA 23454
Phone (757) 481-3500

1004 Independence Blvd
Virginia Beach, VA 23455
Phone (757) 464-4058

1948 Landstown Centre Way
Virginia Beach, VA 23456
Phone (751) 821-7500

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1629543129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 LONDON BLVD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073405",
            "telephone_number": "757-861-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 LONDON BLVD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073405",
            "telephone_number": "757-861-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARROLETTI",
        "first_name": "LYNDA",
        "middle_name": "CAROL",
        "credential": "AGPCNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "C-APN.0101222-C-NP",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024177066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.