Individual provider Active NPI

Michelle R Jowdy, D.O.

  • Pediatrics Physician
  • Newport News, VA
National Provider Identifier
1720283112
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0102206420 Issued in VA
Practice address
10510 Jefferson Ave Ste E
Newport News, VA 23601-3102
Phone
(757) 594-2846
Fax
(757) 594-1714
NPI assigned
Jun 18, 2007
Last updated
Dec 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 611 NE
Pediatrics Physician 208000000X 0102206420 VA Primary

Addresses

Primary practice location

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

Mailing address

856 J Clyde Morris Blvd Ste a
Newport News, VA 23601-1318
Phone (757) 316-5800

Other practice location 1

6301 Gaston Ave
Suite 125P
Dallas, TX 75214-3922
Phone (214) 414-2805

Other names 1

  • Michelle R Jowdy Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160120000084 TX Practitioner - Pediatric Medicine 5193028546 Reassigns benefits to 1 organization
I20211209001309 VA Practitioner - Pediatric Medicine 5193028546 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
611NEMDPediatrics Physician
0102206420VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Hospital Inc. Pediatrics CurrentSince Jan 10, 2022 Accepting new patients
Healthtexas Provider Network CurrentSince Jan 1, 2016 Accepting new patients
Riverside Hospital Inc CurrentSince Jan 10, 2022 Accepting new patients
Riverside Hospital Inc Current Accepting new patients
Healthtexas Provider Network Pediatrics CurrentSince Jan 1, 2016 Accepting new patients

Locations

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (469) 800-8648

10510 Jefferson Ave
Ste A
Newport News, VA 23601
Phone (757) 594-3800

10510 Jefferson Ave
Ste E
Newport News, VA 23601
Phone (757) 594-2846

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

Interoperability endpoints

  • Direct secure messaging: mjowdy181370@direct.rivhs.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1720283112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD STE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318",
            "telephone_number": "757-316-5800",
            "fax_number": "757-534-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10510 JEFFERSON AVE STE E",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236013102",
            "telephone_number": "757-594-2846",
            "fax_number": "757-594-1714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6301 Gaston Ave",
            "address_2": "Suite 125P",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752143922",
            "country_code": "US",
            "telephone_number": "214-414-2805",
            "fax_number": "469-334-0507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOWDY",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "611",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0102206420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "JOWDY",
            "middle_name": "R",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.