Individual provider Active NPI

Rachel Mayer, MD

  • Pediatrics Physician
  • Newport News, VA
National Provider Identifier
1669903399
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101269490 Issued in VA
Practice address
12705 McManus Blvd
Newport News, VA 23602-4459
Phone
(757) 668-4800
NPI assigned
Mar 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101269490 VA Primary

Addresses

Primary practice location

12705 McManus Blvd
Newport News, VA 23602-4459

Mailing address

4072 River Shore Rd
Portsmouth, VA 23703-2057
Phone (757) 374-0479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101269490VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Medical Group, Inc., D/B/a Liberty Pediatrics Pediatrics CurrentSince Mar 3, 2024 Accepting new patients
Childrens Medical Group Inc Pediatrics PastSince Jul 5, 2020 Accepting new patients

Locations

12705 McManus Blvd
Newport News, VA 23602
Phone (757) 668-4800

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.

NPI Registry JSON

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1669903399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4072 RIVER SHORE RD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237032057",
            "telephone_number": "757-374-0479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12705 MCMANUS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024459",
            "telephone_number": "757-668-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "RACHEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101269490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.