Niklas Walter Mikelson, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Luray, VA
NPI 1659115673 · NPPES record last updated Aug 14, 2024
Key facts
- NPI
- 1659115673
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 0024190524 (VA)
- Practice address
- 250 Memorial Dr Ste D
Luray, VA 22835-1000 - Phone
- (804) 586-4425
- NPI assigned
- Jun 24, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Page Memorial Hospital Inc
Practice addresses (Care Compare)
125 Memorial Dr
Luray, VA 22835-1016
Phone (540) 743-2822
135 Memorial Dr
Luray, VA 22835-1016
Phone (540) 743-2887
Hospital & facility affiliations
- Valley Health Home Health
- Page Memorial Hospital, Inc
- Winchester Medical Center
- Sentara RMH Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240730000985 | VA | Practitioner - Family Practice | 5496292229 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Page Memorial Hospital, Inc. | Current |
Accepting new patients | |
| Page Memorial Hospital, Inc. | Family | Current |
Accepting new patients |
| Page Memorial Hospital Inc. | Past | Accepting new patients | |
| Page Memorial Hospital Inc. | Past | Accepting new patients |
Locations
250 Memorial Dr
#D
Luray, VA 22835
Phone (540) 743-6558
200 Memorial Dr
Luray, VA 22835
Phone (540) 743-4561
125 Memorial Dr
Luray, VA 22835
Phone (540) 743-2282
135 Memorial Dr
Luray, VA 22835
Phone (540) 743-2887
220 Campus Blvd
Ste 320
Winchester, VA 22601
Interoperability endpoints
- nmikelson1101776@valleyhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024190524 | VA | Yes |
Addresses
Primary practice location
250 Memorial Dr Ste D
Luray, VA 22835-1000
Mailing address
130 Shenandale Dr
McGaheysville, VA 22840-2148
Phone (804) 586-4425
Other practice location 1
135 Memorial Dr
Luray, VA 22835-1016
Phone (540) 743-2887
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Nmikelson1101776@ValleyHealth.direct-ci.com |
Other providers in Luray, VA
- Luray Dental Health Center, PC
- Ashley Marie Mann
- Karen Elaine Marshall
- Mary Fleury Mayfield
- McKim and Huffman Inc
- Charles Miller
- David Brooke Miller
- Bradley Keller Moyer
- Nicole Mueller
- MV Operations LLC
All providers in Luray, VA · Family Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.