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
Last updated
Feb 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 2

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

Addresses

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

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

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

Practice addresses (Care Compare)

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

Hospital & facility affiliations

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
MCV Associated Physicians CurrentSince Jul 14, 2019 Accepting new patients
Bon Secours Memorial Regional Medical Center LLC Current 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

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

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

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

Interoperability endpoints

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

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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": "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.