Individual provider Active NPI

Wander Everett

  • Acute Care Nurse Practitioner
  • Henrico, VA
National Provider Identifier
1659060382
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
0001251326 Issued in VA
Practice address
1722 Foxfire Cir
Henrico, VA 23238-4212
Phone
(804) 839-8830
NPI assigned
May 8, 2023
Last updated
May 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0001251326 VA Primary

Addresses

Primary practice location

1722 Foxfire Cir
Henrico, VA 23238-4212

Mailing address

1722 Foxfire Cir
Henrico, VA 23238-4212
Phone (804) 839-8830

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
I20240704000119 VA Practitioner - Nurse Practitioner 0345784062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geriatric Associates of Richmond IncGroup PAC ID 4789026071, 22 clinicians

Practice addresses (Care Compare)

5310 Twin Hickory Rd
Glen Allen, VA 23059-5783
Phone (804) 714-6291

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001251326VAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric Associates of Richmond Inc CurrentSince Apr 7, 2024 Accepting new patients
Express Med Urgent Care Center, Inc PastSince Apr 7, 2024 Accepting new patients

Locations

5310 Twin Hickory Rd
Glen Allen, VA 23059
Phone (804) 360-4242

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1659060382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 FOXFIRE CIR",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232384212",
            "telephone_number": "804-839-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 FOXFIRE CIR",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232384212",
            "telephone_number": "804-839-8830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERETT",
        "first_name": "WANDER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0001251326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

Verify at the official NPI Registry.