Active NPI
Jessica Grace Staples
- Physician Assistant
- Virginia Beach, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110007709
- Practice address
- 1232 Perimeter Pkwy Ste 100
Virginia Beach, VA 23454-5924 - Phone
- (757) 821-2088
- Fax
- (757) 821-2081
- NPI assigned
- Feb 4, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | 0110007709 | VA | Primary |
Addresses
Primary practice location
1232 Perimeter Pkwy Ste 100
Virginia Beach, VA 23454-5924
Mailing address
1232 Perimeter Pkwy Ste 100
Virginia Beach, VA 23454-5924
Phone (757) 821-2088
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
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
101 A York Crossing
Grafton, VA 23692
Phone (757) 898-7737
860 Omni Blvd
Newport News, VA 23606-4430
Hospital & facility affiliations
- Sentara Princess Anne Hospital
- Sentara Virginia Beach General Hospital
- Sentara Leigh Hospital
- Bon Secours Maryview Medical Center
- Sentara Norfolk General Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tidewater Physicians Multispecialty Group PC | Current | Accepting new patients | |
| Tidewater Physicians Multispecialty Group PC | Current | Accepting new patients |
Locations
101 York Crossing Rd
#A
Grafton, VA 23692
Phone (757) 898-7737
827 Diligence Dr
Ste 100
Newport News, VA 23606
860 Omni Blvd
Ste 101
Newport News, VA 23606
Phone (757) 223-9794
860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138
729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077
1232 Perimeter Pkwy
Ste 100
Virginia Beach, VA 23454
Phone (757) 219-2785
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BGFHDD
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Newport News, VA
- NPI 1902848294
-
- Ambulatory Surgical Clinic/Center
- Williamsburg, VA
- NPI 1316790512
Hospital & facility affiliations 14
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portsmouth, VA
- NPI 1750399192
-
- General Acute Care Hospital
- Norfolk, VA
- NPI 1437119310
-
- General Acute Care Hospital
- Virginia Beach, VA
- NPI 1629038336
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645488000000",
"number": "1760014153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1232 PERIMETER PKWY STE 100",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234545924",
"telephone_number": "757-821-2088",
"fax_number": "757-821-2081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1232 PERIMETER PKWY STE 100",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234545924",
"telephone_number": "757-821-2088",
"fax_number": "757-821-2081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAPLES",
"first_name": "JESSICA",
"middle_name": "GRACE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-04",
"last_updated": "2022-02-22",
"certification_date": "2022-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110007709",
"primary": true
}
],
"identifiers": [],
"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 Feb 22, 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.