NPIMap

Individual provider Active NPI

Jill S Storment, AGPCNP

  • Primary Care Nurse Practitioner
  • King William, VA
National Provider Identifier
1669945663
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
0024177236 Issued in VA
Practice address
1041 Sharon Rd Ste 205
King William, VA 23086-3344
Phone
(804) 769-3096
Fax
(804) 769-3170
NPI assigned
Jan 2, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 6

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 8

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

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bon Secours Memorial Regional Medical Center LLC 15 clinicians

Practice addresses (Care Compare)

1041 Sharon Rd
Suite 205
King William, VA 23086-3344
Phone (804) 746-1677

Hospital & facility affiliations

  • Bon Secours Memorial Regional Medical Center Hospital, Mechanicsville, VA, CCN 490069
  • Bon Secours St Marys Hospital Hospital, Richmond, VA, CCN 490059
  • Vcu Health Tappahannock Hospital Hospital, Tappahannock, VA, CCN 490084

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
I20190930002626 VA Practitioner - Nurse Practitioner 8628308913 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024177236VAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours - Memorial Regional Medical Center, Inc. CurrentSince Jul 14, 2024 Accepting new patients
Bon Secours Memorial Regional Medical Center LLC CurrentSince Jul 14, 2024 Accepting new patients
Bon Secours Memorial Regional Medical Center LLC Current Accepting new patients
MCV Associated Physicians CurrentSince Jul 14, 2019 Accepting new patients
Bon Secours Memorial Regional Medical Center LLC Past Accepting new patients

Locations

1041 Sharon Rd
Ste 205
King William, VA 23086
Phone (804) 746-1677

8220 Meadowbridge Rd
Ste 203
Mechanicsvlle, VA 23116
Phone (804) 226-2444

417 N 11th St
Richmond, VA 23298
Phone (804) 828-0733

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

1250 E Marshall St
Richmond, VA 23298
Phone (804) 628-6990

Interoperability endpoints

  • Direct secure messaging: jstorment2616409@direct.bsmhealth.org

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0024177236 VA
Primary Care Nurse Practitioner 363LP2300X 0024177236 VA Primary

Addresses

NPPES NPI Registry

Primary practice location

1041 Sharon Rd Ste 205
King William, VA 23086-3344

Mailing address

1041 Sharon Rd Ste 205
King William, VA 23086-3344
Phone (804) 769-3096

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 5, 2025.

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1669945663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 SHARON RD STE 205",
            "city": "KING WILLIAM",
            "state": "VA",
            "postal_code": "230863344",
            "telephone_number": "804-769-3096",
            "fax_number": "804-769-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 SHARON RD STE 205",
            "city": "KING WILLIAM",
            "state": "VA",
            "postal_code": "230863344",
            "telephone_number": "804-769-3096",
            "fax_number": "804-769-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORMENT",
        "first_name": "JILL",
        "middle_name": "S",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-02",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024177236",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VA",
            "license": "0024177236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King William, VA

Sources for this page

Verify at the official NPI Registry.