NPIMap

Individual provider Active NPI

Mahealani Roach, FNP

  • Family Nurse Practitioner
  • Powhatan, VA
National Provider Identifier
1649730292
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024177415 Issued in VA
Practice address
2891 Anderson Hwy
Powhatan, VA 23139-7406
Phone
(804) 897-1259
NPI assigned
Mar 20, 2019
Last updated
Mar 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024177415 VA Primary

Addresses

Primary practice location

2891 Anderson Hwy
Powhatan, VA 23139-7406

Mailing address

2891 Anderson Hwy
Powhatan, VA 23139-7406
Phone (804) 897-1259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190515002206 VA Practitioner - Nurse Practitioner 5092058040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians
Professional Therapies of Roanoke, Inc.Group PAC ID 3375710619, shared by 5 NPIs, 272 clinicians

Practice addresses (Care Compare)

2410 Pagehurst Dr
Midlothian, VA 23113-6411
Phone (804) 897-6140

6800 Woodlake Commons Loop
Midlothian, VA 23112-2281
Phone (804) 302-4589

8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024177415VAMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: mahealani.roach.1@8042.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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1649730292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2891 ANDERSON HWY",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231397406",
            "telephone_number": "804-897-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2891 ANDERSON HWY",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231397406",
            "telephone_number": "804-897-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "MAHEALANI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024177415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powhatan, VA

Sources for this page

Verify at the official NPI Registry.