Individual provider Active NPI

Shirley Frias O'Neal, RN, FNP-C

  • Family Nurse Practitioner
  • Suffolk, VA
National Provider Identifier
1790467173
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024187882 Issued in VA
Practice address
1009 Centerbrooke LN Ste 201
Suffolk, VA 23434-8664
Phone
(757) 209-4794
NPI assigned
Aug 3, 2023
Last updated
Oct 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024187882 VA Primary
Registered Nurse 163W00000X 0001261175 VA

Addresses

Primary practice location

1009 Centerbrooke LN Ste 201
Suffolk, VA 23434-8664

Mailing address

1133 Killington Arch
Chesapeake, VA 23320-8255
Phone (757) 773-9442

Other names 1

  • Shirley Maria Flor Mendoza Frias Former 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
I20231229002369 VA Practitioner - Nurse Practitioner 4981054152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roanoke Valley Healthcare Partners LLCGroup PAC ID 0143490326, 53 clinicians

Practice addresses (Care Compare)

1013 University Blvd
Suite 270
Suffolk, VA 23435-3900
Phone (757) 335-4755

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001261175VAMDRegistered Nurse
0024187882VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roanoke Valley Healthcare Partners, LLC CurrentSince Dec 18, 2023 Accepting new patients
Blue Ridge Healthcare Partners, LLC PastSince Dec 18, 2023 Accepting new patients

Locations

9276 Old Keene Mill Rd
Burke, VA 22015
Phone (571) 516-3116

1119 N Military Hwy
Ste 300
Norfolk, VA 23502
Phone (757) 224-3004

602 Brandon Ave SW
Ste 222
Roanoke, VA 24015
Phone (540) 774-0000

1013 University Blvd
Ste 270
Suffolk, VA 23435
Phone (757) 335-4755

14087 Richmond Hwy
Ste 101
Woodbridge, VA 22191
Phone (571) 300-8000

4101 Cheshire Station Plz
Ste 500
Woodbridge, VA 22193
Phone (571) 374-1234

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1790467173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 KILLINGTON ARCH",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233208255",
            "telephone_number": "757-773-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 CENTERBROOKE LN STE 201",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348664",
            "telephone_number": "757-209-4794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEAL",
        "first_name": "SHIRLEY",
        "middle_name": "FRIAS",
        "credential": "RN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-03",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024187882",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001261175",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIRLEY MARIA FLOR",
            "last_name": "FRIAS",
            "middle_name": "MENDOZA",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.