Individual provider Active NPI

Brittany Rochelle Irwin, PAC

  • Physician Assistant
  • Chesapeake, VA
National Provider Identifier
1740563485
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110003663 Issued in VA
Practice address
736 Battlefield Blvd N
Chesapeake, VA 23320-4941
Phone
(757) 490-9388
Fax
(757) 490-9401
NPI assigned
Sep 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110003663 VA Primary

Addresses

Primary practice location

736 Battlefield Blvd N
Chesapeake, VA 23320-4941

Mailing address

4536 Bonney Rd
Virginia Beach, VA 23462-3818
Phone (757) 490-9388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111025000401 VA Practitioner - Physician Assistant 7517130222 Reassigns benefits to 1 organization
I20240826001083 FL Practitioner - Physician Assistant 7517130222 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce L Boros MD PA CurrentSince May 31, 2024 Accepting new patients
Tidewater Emergency Medical Care Physician Assistant PastSince Feb 2, 2020 Accepting new patients

Locations

100460 Overseas Hwy
Ste 4
Key Largo, FL 33037
Phone (305) 453-3337

1980 N Roosevelt Blvd
Key West, FL 33040
Phone (305) 294-0011

Organizations & group practices 4

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": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1740563485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4536 BONNEY RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623818",
            "telephone_number": "757-490-9388",
            "fax_number": "757-940-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 BATTLEFIELD BLVD N",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204941",
            "telephone_number": "757-490-9388",
            "fax_number": "757-490-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRWIN",
        "first_name": "BRITTANY",
        "middle_name": "ROCHELLE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.