Active NPI
Charles Eshel Stith III, NP
- Pediatric Nurse Practitioner
- Hampton, VA
National Provider Identifier
1770183303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 0024181317
- Practice address
- 23 Manhattan SQ
Hampton, VA 23666-5843 - Phone
- (757) 668-2200
- Fax
- (757) 668-2222
- NPI assigned
- Nov 1, 2020
- Last updated
- Oct 14, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0001267153 | VA | |
| Pediatric Nurse Practitioner | 363LP0200X | 0024181317 | VA | Primary |
Addresses
Primary practice location
23 Manhattan SQ
Hampton, VA 23666-5843
Mailing address
23 Manhattan SQ
Hampton, VA 23666-5843
Phone (757) 668-2200
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | stithiiice@gmail.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0001267153 | VA | MD | Pediatrics Physician |
Interoperability endpoints
- charles.stith.1@2802.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634169600000",
"number": "1770183303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 MANHATTAN SQ",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236665843",
"telephone_number": "757-668-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 MANHATTAN SQ",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236665843",
"telephone_number": "757-668-2200",
"fax_number": "757-668-2222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STITH",
"first_name": "CHARLES",
"middle_name": "ESHEL",
"name_suffix": "III",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-01",
"last_updated": "2021-10-14",
"certification_date": "2021-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0001267153",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "VA",
"license": "0024181317",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "stithiiice@gmail.com",
"affiliation": "N",
"endpointDescription": "home",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Email",
"address_1": "317 Middle Oaks Dr",
"city": "Chesapeake",
"state": "VA",
"country_code": "US",
"postal_code": "233227502",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Hampton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.