Individual provider Active NPI

Laura R Kreisa, NP

  • Family Nurse Practitioner
  • Henrico, VA
National Provider Identifier
1669804464
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0017141115 Issued in VA
Practice address
1257 Marywood LN
Henrico, VA 23229-6059
Phone
(804) 741-8624
Fax
(804) 740-3865
NPI assigned
Aug 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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 0017141115 VA Primary

Addresses

Primary practice location

1257 Marywood LN
Henrico, VA 23229-6059

Mailing address

1257 Marywood LN
Henrico, VA 23229-6059
Phone (804) 741-8624

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
I20170927000956 VA Practitioner - Nurse Practitioner 8325276090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SNF LTC Partners of VirginiaGroup PAC ID 4789014150, 28 clinicians

Practice addresses (Care Compare)

1776 Cambridge Dr
Richmond, VA 23238-3203
Phone (804) 543-2120

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0017141115VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SNF LTC Partners of Virginia CurrentSince Jun 5, 2023 Accepting new patients
Brydig, LLC PastSince Mar 29, 2020 Accepting new patients

Locations

14001 Turnberry Ln
Midlothian, VA 23113
Phone (804) 897-2727

13800 Bon Secours Dr
Midlothian, VA 23114
Phone (804) 378-5100

2100 Brandermill Pkwy
Midlothian, VA 23112
Phone (804) 379-7100

567 N Parham Rd
Richmond, VA 23229
Phone (571) 491-8887

2300 Cedarfield Pkwy
Richmond, VA 23233
Phone (804) 474-8800

1776 Cambridge Dr
Richmond, VA 23238
Phone (804) 368-6474

13700 N Gayton Rd
Richmond, VA 23233
Phone (804) 360-1960

1807 N Parham Rd
Richmond, VA 23229
Phone (804) 325-4403

20 Delfae Dr
Warsaw, VA 22572
Phone (804) 313-2400

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1669804464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 MARYWOOD LN",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232296059",
            "telephone_number": "804-741-8624",
            "fax_number": "804-740-3865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1257 MARYWOOD LN",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232296059",
            "telephone_number": "804-741-8624",
            "fax_number": "804-740-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREISA",
        "first_name": "LAURA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-02",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0017141115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

Verify at the official NPI Registry.