Individual provider Active NPI

Nicole J Ha, DO

  • Family Medicine Physician
  • Hampton, VA
National Provider Identifier
1689253965
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102207887 Issued in VA
Practice address
2304 W Mercury Blvd
Hampton, VA 23666-3115
Phone
(757) 951-1579
NPI assigned
Apr 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0102207887 VA Primary

Addresses

Primary practice location

2304 W Mercury Blvd
Hampton, VA 23666-3115

Mailing address

10510 Jefferson Ave Ste B
Newport News, VA 23601-3102

Other practice location 1

10510 Jefferson Ave Ste B
Newport News, VA 23601-3102
Phone (757) 594-3890

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address VAExchange@patientfirstclinics.com Health Information Exchange (HIE)
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230712001985 DC Practitioner - Family Practice 7810390069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

6104 Old Branch Ave
Temple Hills, MD 20748-2518
Phone (301) 702-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102207887VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Aug 12, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Aug 12, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Family Medicine Current Accepting new patients

Locations

4000 Garden City Dr
Fl 4
Hyattsville, MD 20785
Phone (227) 229-8532

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

Organizations & group practices 3

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": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1689253965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10510 JEFFERSON AVE STE B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236013102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 W MERCURY BLVD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236663115",
            "telephone_number": "757-951-1579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10510 Jefferson Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236013102",
            "country_code": "US",
            "telephone_number": "757-594-3890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HA",
        "first_name": "NICOLE",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102207887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2304 W Mercury Blvd",
            "city": "Hampton",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236663115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10510 Jefferson Ave Ste B",
            "city": "Newport News",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236013102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.