Individual provider Active NPI

Connie Ngoc Fletcher

  • Psychiatric/Mental Health Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1760026272
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024187399 Issued in VA
Practice address
3388 Princess Anne Rd Ste 2001
Virginia Beach, VA 23456-2612
Phone
(757) 507-7270
NPI assigned
Oct 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95018234 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024187399 VA Primary

Addresses

Primary practice location

3388 Princess Anne Rd Ste 2001
Virginia Beach, VA 23456-2612

Mailing address

3388 Princess Anne Rd Ste 2001
Virginia Beach, VA 23456-2612
Phone (757) 507-7270

Other practice location 1

140 Arbor Dr
San Diego, CA 92103-2007
Phone (619) 543-6047

Other names 1

  • Connie N Quach Other name

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
I20240207004292 VA Practitioner - Nurse Practitioner 9335582246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

3388 Princess Anne Rd
Suite 2001
Virginia Beach, VA 23456-2612
Phone (757) 507-7270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95018234CAMDPsychiatric/Mental Health Nurse Practitioner
0024187399VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Sentara Medical Group CurrentSince Jan 1, 2024 Accepting new patients

Locations

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

3388 Princess Anne Rd
Ste 2001
Virginia Beach, VA 23456
Phone (757) 227-5055

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.

NPI Registry JSON

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1760026272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3388 PRINCESS ANNE RD STE 2001",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234562612",
            "telephone_number": "757-507-7270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3388 PRINCESS ANNE RD STE 2001",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234562612",
            "telephone_number": "757-507-7270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032007",
            "country_code": "US",
            "telephone_number": "619-543-6047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "CONNIE",
        "middle_name": "NGOC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95018234",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024187399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "QUACH",
            "middle_name": "N",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.