Fortunata S Condecido, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024169248 Issued in VA

Practice address

514 W Atlantic St
South Hill, VA 23970-1906

Phone

(434) 584-2000

Fax

(434) 447-2240

NPI assigned

Mar 8, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Home health agency, Midlothian, VA, CCN 497538
• Community Memorial Hospital Hospital, South Hill, VA, CCN 490098
• Medical College of Virginia Hospitals Hospital, Richmond, VA, CCN 490032

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fortunata.condecido.1@8042.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

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.

• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480
  Medicare reassignment Care Compare group NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Lawrenceville Primary Care PC

  • Internal Medicine Physician
  • Lawrenceville, VA
  • NPI 1881624682
  NPD (past)
• Nova Physician Wellness Center PLLC

  • Family Medicine Physician
  • Fairfax, VA
  • NPI 1215307400
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Home Health Inc of Virginia

  • Home Health Agency
  • Petersburg, VA
  • NPI 1225157514
  Care Compare affiliation
• Amedisys Home Health of Virginia LLC

  • Home Health Agency
  • Goochland, VA
  • NPI 1306964168
  Care Compare affiliation
• Amedisys Home Health of Virginia LLC

  • Home Health Agency
  • Crewe, VA
  • NPI 1609994573
  Care Compare affiliation
• Amedisys Home Health of Virginia LLC

  • Home Health Agency
  • Midlothian, VA
  • NPI 1669420337
  Care Compare affiliation
• Amedisys Home Health, Inc. of Virginia

  • Home Health Agency
  • Mechanicsville, VA
  • NPI 1053409250
  Care Compare affiliation
• Amedisys Home Health, Inc. of Virginia

  • Home Health Agency
  • Charlottesville, VA
  • NPI 1558489948
  Care Compare affiliation
• Community Memorial Hospital

  • General Acute Care Hospital
  • South Hill, VA
  • NPI 1336103738
  Care Compare affiliation
• Virginia Commonwealth University Health System Authority

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1013091727
  Care Compare affiliation
• Virginia Commonwealth University Health System Authority

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1437175734
  Care Compare affiliation

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1730487299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 W ATLANTIC ST",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239701906",
            "telephone_number": "434-584-2000",
            "fax_number": "434-447-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 W ATLANTIC ST",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239701906",
            "telephone_number": "434-584-2000",
            "fax_number": "434-447-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDECIDO",
        "first_name": "FORTUNATA",
        "middle_name": "S",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-08",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024169248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730487299",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1730487299",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER",
            "identifier": "540551711",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER",
            "identifier": "542019967",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Memorial Hospital
• Community Memorial Hospital
• Community Memorial Hospital
• Community Memorial Hospital
• Community Memorial Hospital
• Cornerstone Behavioral Health Services Inc
• Heather Morris Corwin, PHARMD
• Diana P Crowder, PAC
• Kristen Damon, FNP
• Hayley Daniel

• Family Nurse Practitioner in South Hill, VA
• Providers in South Hill, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.

Verify at the official NPI Registry.