NPIMap

Individual provider Active NPI

Nicole Bussiere, MD

  • Family Medicine Physician
  • Henrico, VA
National Provider Identifier
1780065979
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101276360 Issued in VA
Practice address
3400 Haydenpark LN Ste 300
Henrico, VA 23233-7867
Phone
(804) 998-1600
Fax
(804) 998-1601
NPI assigned
Jun 12, 2015
Last updated
Aug 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101276360 VA Primary

Addresses

Primary practice location

3400 Haydenpark LN Ste 300
Henrico, VA 23233-7867

Mailing address

3400 Haydenpark LN Ste 300
Henrico, VA 23233-7867
Phone (804) 998-1600

Other names 1

  • Nicole Smith Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230119001322 VA Practitioner - Family Practice 5395015218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Therapies of Roanoke, Inc.Group PAC ID 3375710619, shared by 5 NPIs, 272 clinicians
Partner MD PCGroup PAC ID 8022002617, 24 clinicians

Practice addresses (Care Compare)

3000 G Stony Point Rd
Richmond, VA 23235-2349
Phone (804) 877-0008

7001 Forest Ave
Suite 302
Richmond, VA 23230-1726
Phone (804) 282-2655

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101276360VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Partner MD PC Family Medicine CurrentSince Jan 9, 2023 Accepting new patients

Locations

13901 Coalfield Commons Pl
Midlothian, VA 23114
Phone (804) 420-1200

3400 Haydenpark Ln
Ste 300
Richmond, VA 23233
Phone (804) 998-1600

7001 Forest Ave
Ste 302
Richmond, VA 23230
Phone (703) 288-3750

Interoperability endpoints

  • Direct secure messaging: nbussiere188688@direct.thedacare.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1780065979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 HAYDENPARK LN STE 300",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232337867",
            "telephone_number": "804-998-1600",
            "fax_number": "804-998-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 HAYDENPARK LN STE 300",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232337867",
            "telephone_number": "804-998-1600",
            "fax_number": "804-998-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSIERE",
        "first_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101276360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "SMITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Henrico, VA

Sources for this page

Verify at the official NPI Registry.