Individual provider Active NPI

Freda Colston Estillore, NP

  • Family Nurse Practitioner
  • Norfolk, VA
National Provider Identifier
1891325668
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024178642 Issued in VA
Practice address
850 Kempsville Rd Ste 200B
Norfolk, VA 23502-3920
Phone
(757) 261-5999
Fax
(757) 466-0321
NPI assigned
Jan 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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 0024178642 VA Primary

Addresses

Primary practice location

850 Kempsville Rd Ste 200B
Norfolk, VA 23502-3920

Mailing address

850 Kempsville Rd Ste 200B
Norfolk, VA 23502-3920
Phone (757) 261-5999

Other practice location 1

4360 Shore Dr Ste 101
Virginia Beach, VA 23455-2994
Phone (866) 933-8387

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
I20240221003429 VA Practitioner - Nurse Practitioner 2567806276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

850 Kempsville Rd
Norfolk, VA 23502-3920
Phone (757) 261-0162

Hospital & facility affiliations

  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Bon Secours Maryview Medical Center Hospital, Portsmouth, VA, CCN 490017

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024178642VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Feb 1, 2024 Accepting new patients

Locations

850 Kempsville Rd
Ste 200B
Norfolk, VA 23502
Phone (757) 261-5910

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

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 and National Provider Directory roles.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1891325668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 KEMPSVILLE RD STE 200B",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023920",
            "telephone_number": "757-261-5999",
            "fax_number": "757-466-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 KEMPSVILLE RD STE 200B",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023920",
            "telephone_number": "757-261-5999",
            "fax_number": "757-466-0321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4360 Shore Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234552994",
            "country_code": "US",
            "telephone_number": "866-933-8387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTILLORE",
        "first_name": "FREDA",
        "middle_name": "COLSTON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-21",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024178642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.