Active NPI
Chassitie L Gomez, APRN
- Family Nurse Practitioner
- Virginia Beach, VA
National Provider Identifier
1720574726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 0024176292
- Practice address
- 2901 S Lynnhaven Rd Ste 450
Virginia Beach, VA 23452-8524 - Phone
- (757) 536-2246
- Fax
- (757) 965-9806
- NPI assigned
- Jul 3, 2018
- Last updated
- Oct 7, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN11005890 | FL | |
| Family Nurse Practitioner | 363LF0000X | 0024176292 | VA | Primary |
| Registered Nurse | 163W00000X | 0001234356 | VA |
Addresses
Primary practice location
2901 S Lynnhaven Rd Ste 450
Virginia Beach, VA 23452-8524
Mailing address
7855 Argyle Forest Blvd Ste 101
Jacksonville, FL 32244-5597
Phone (904) 282-6331
Other practice location 1
14810 Old Saint Augustine Rd Ste 101
Jacksonville, FL 32258-2558
Phone (904) 260-4111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 105822400 | Medicaid | FL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Norfolk, VA 23502
Phone (757) 354-2885
6160 Kempsville Cir
Suite 325a
Norfolk, VA 23502-3933
Phone (757) 354-2885
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0001234356 | VA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-Atlantic Post Acute & Long Term Care PLLC | Family | Current | Accepting new patients |
| SE Virginia Value Based Care, LLC | Current | Accepting new patients |
Locations
6160 Kempsville Cir
Ste 325A
Norfolk, VA 23502
Phone (757) 354-2885
Organizations & group practices 2
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.
-
- Geriatric Medicine (Internal Medicine) Physician
- Norfolk, VA
- NPI 1225557556
Family
-
- Geriatric Medicine (Internal Medicine) Physician
- Norfolk, VA
- NPI 1225720501
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Virginia Beach, VA
- NPI 1528028396
-
- Home Health Agency
- Newport News, VA
- NPI 1568695278
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665100800000",
"number": "1720574726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7855 ARGYLE FOREST BLVD STE 101",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322445597",
"telephone_number": "904-282-6331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 S LYNNHAVEN RD STE 450",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234528524",
"telephone_number": "757-536-2246",
"fax_number": "757-965-9806"
}
],
"practiceLocations": [
{
"address_1": "14810 Old Saint Augustine Rd Ste 101",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322582558",
"country_code": "US",
"telephone_number": "904-260-4111",
"fax_number": "904-264-9750",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOMEZ",
"first_name": "CHASSITIE",
"middle_name": "L",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-03",
"last_updated": "2022-10-07",
"certification_date": "2022-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN11005890",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "VA",
"license": "0024176292",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "VA",
"license": "0001234356",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "105822400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.