Individual provider Active NPI

Jessica L Vantuyle, MD

  • Obstetrics & Gynecology Physician
  • Henrico, VA
National Provider Identifier
1831163146
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0101102674 Issued in VA
Practice address
1603 Skipwith Rd
Henrico, VA 23229-5253
Phone
(804) 507-1644
Fax
(804) 507-0116
NPI assigned
Feb 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 0101102674 VA Primary

Addresses

Primary practice location

1603 Skipwith Rd
Henrico, VA 23229-5253

Mailing address

PO Box 7650
Henrico, VA 23231-0150
Phone (804) 507-1644

Other identifiers 1

IdentifierTypeStateIssuer
1831163146MedicaidVA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100723000578 VA Practitioner - Obstetrics/Gynecology 1658403845 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Jefferson Medical College of Thomas Jefferson University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Obhg Virginia LLCGroup PAC ID 9436323342, 46 clinicians

Practice addresses (Care Compare)

5801 Bremo Rd
Richmond, VA 23226-1907
Phone (800) 967-2289

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101102674VAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Virginia, LLC Obstetrics & Gynecology CurrentSince Jul 25, 2016 Accepting new patients
Virginia Physicians for Women LTD Obstetrics & Gynecology CurrentSince May 5, 2020 Accepting new patients
Virginia Womens Center Inc CurrentSince Oct 17, 2016 Accepting new patients
OB Hospitalist Inc Past Accepting new patients

Locations

13710 St Francis Blvd
Midlothian, VA 23114
Phone (804) 594-7300

13801 St Francis Blvd
Ste 150
Midlothian, VA 23114

7130 Glen Forest Dr
Ste 101
Richmond, VA 23226

5875 Bremo Rd
Ste 400
Richmond, VA 23226
Phone (804) 287-3550

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.405

Organizations & group practices 4

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1831163146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7650",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232310150",
            "telephone_number": "804-507-1644",
            "fax_number": "804-507-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 SKIPWITH RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232295253",
            "telephone_number": "804-507-1644",
            "fax_number": "804-507-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANTUYLE",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101102674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831163146",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

Verify at the official NPI Registry.