Individual provider Active NPI

Gaylen Q Tassell, NP

  • Family Nurse Practitioner
  • Chester, VA
National Provider Identifier
1861895336
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024164429 Issued in VA
Practice address
12340 Bermuda Crossroad LN
Chester, VA 23831-2352
Phone
(804) 287-4550
Fax
(804) 717-8292
NPI assigned
Sep 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

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 0024164429 VA Primary

Addresses

Primary practice location

12340 Bermuda Crossroad LN
Chester, VA 23831-2352

Mailing address

12340 Bermuda Crossroad LN
Chester, VA 23831-2352
Phone (804) 287-4550

Other identifiers 1

IdentifierTypeStateIssuer
C09633OtherVAGROUP PTAN

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
I20141231001568 VA Practitioner - Nurse Practitioner 2567785355

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024164429VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St Francis Medical Center LLC Past Accepting new patients
Bon Secours St. Francis Medical Center LLC Past Accepting new patients
Cardiac & Thoracic Surgical Associates, LTD Past Accepting new patients
Bon Secours St. Francis Medical Center Inc Past Accepting new patients
Bon Secours St. Francis Medical Center Inc Past Accepting new patients

Organizations & group practices 5

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": "1411948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411948800000",
    "number": "1861895336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12340 BERMUDA CROSSROAD LN",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238312352",
            "telephone_number": "804-287-4550",
            "fax_number": "804-717-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12340 BERMUDA CROSSROAD LN",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238312352",
            "telephone_number": "804-287-4550",
            "fax_number": "804-717-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TASSELL",
        "first_name": "GAYLEN",
        "middle_name": "Q",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-29",
        "last_updated": "2014-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024164429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C09633",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, VA

Sources for this page

Verify at the official NPI Registry.