Individual provider Active NPI

Jessica L Waddell, NP-C

  • Family Nurse Practitioner
  • Norfolk, VA
National Provider Identifier
1861739377
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024170450 Issued in VA
Practice address
844 Kempsville Rd Ste 204
Norfolk, VA 23502-3927
Phone
(757) 461-0700
Fax
(757) 461-0701
NPI assigned
Jan 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024170450 VA Primary

Addresses

Primary practice location

844 Kempsville Rd Ste 204
Norfolk, VA 23502-3927

Mailing address

844 Kempsville Rd Ste 204
Norfolk, VA 23502-3927
Phone (757) 461-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130529000891 VA Practitioner - Nurse Practitioner 5799923983 Reassigns benefits to 1 organization
I20260428000690 FL Practitioner - Nurse Practitioner 5799923983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

844 Kempsville Rd
Suite 204
Norfolk, VA 23502-3927
Phone (757) 261-0700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Feb 10, 2013 Accepting new patients

Locations

300 Medical Pkwy
Ste 120
Chesapeake, VA 23320
Phone (757) 252-5660

844 Kempsville Rd
Ste 204
Norfolk, VA 23502
Phone (757) 261-0700

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

Interoperability endpoints

  • Direct secure messaging: jwaddell15724@direct.sentara.net

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1861739377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 KEMPSVILLE RD STE 204",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023927",
            "telephone_number": "757-461-0700",
            "fax_number": "757-461-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 KEMPSVILLE RD STE 204",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023927",
            "telephone_number": "757-461-0700",
            "fax_number": "757-461-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-04",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024170450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.