Individual provider Active NPI

Jack Weisskohl, MSN, FNP-BC

  • Family Nurse Practitioner
  • Charles City, VA
National Provider Identifier
1720509599
Registry record updated Jul 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024175030 Issued in VA
Practice address
9950 Courthouse Rd
Charles City, VA 23030-3434
Phone
(804) 829-6600
Fax
(804) 829-6182
NPI assigned
Jul 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024175030 VA Primary

Addresses

Primary practice location

9950 Courthouse Rd
Charles City, VA 23030-3434

Mailing address

3101 Midlothian Tpke
Richmond, VA 23224-1925
Phone (703) 282-1297

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171016001173 VA Practitioner - Nurse Practitioner 1254607450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

417 N 11TH St
Richmond, VA 23298-5024
Phone (804) 828-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.95 of 100Reported as group
Quality
69.91
Promoting interoperability
99
Improvement activities
40
Cost
77.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
0024175030VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince Oct 18, 2020 Accepting new patients

Locations

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

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

Organizations & group practices 1

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 2

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": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499040000000",
    "number": "1720509599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 MIDLOTHIAN TPKE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232241925",
            "telephone_number": "703-282-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9950 COURTHOUSE RD",
            "city": "CHARLES CITY",
            "state": "VA",
            "postal_code": "230303434",
            "telephone_number": "804-829-6600",
            "fax_number": "804-829-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISSKOHL",
        "first_name": "JACK",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-03",
        "last_updated": "2017-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024175030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charles City, VA

Sources for this page

Verify at the official NPI Registry.