Individual provider Active NPI

Justin Lee Nolen, P.A.

  • Physician Assistant
  • Fishersville, VA
National Provider Identifier
1891829693
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002178 Issued in VA
Practice address
70 Medical Center Cir Ste 305
Fishersville, VA 22939-2273
Phone
(540) 932-5747
Fax
(540) 932-5748
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002178 VA Primary
Surgical Physician Assistant 363AS0400X 0110002718 VA

Addresses

Primary practice location

70 Medical Center Cir Ste 305
Fishersville, VA 22939-2273

Mailing address

PO Box 388
Fishersville, VA 22939-0388
Phone (540) 932-5747

Other practice location 1

2509 Pleasant Run Dr
Harrisonburg, VA 22801-8720
Phone (540) 689-4500

Other identifiers 1

IdentifierTypeStateIssuer
1891829693MedicaidVA

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
I20080123000027 VA Practitioner - Physician Assistant 1658452115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Augusta Medical GroupGroup PAC ID 3678632544, 409 clinicians

Practice addresses (Care Compare)

2303 N Augusta St
Suite E
Staunton, VA 24401-2597
Phone (540) 886-4510

53 S Medical Park Dr
Fishersville, VA 22939-2333
Phone (540) 332-5687

70 Medical Ctr Cir
Fishersville, VA 22939-2273

9 S Medical Park Dr
Fishersville, VA 22939-2333
Phone (540) 245-7350

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110002178VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Augusta Medical Group CurrentSince Aug 30, 2021 Accepting new patients

Locations

540 Radford Ln
Ste 250
Charlottesville, VA 22903
Phone (434) 823-7596

53 S Medical Park Dr
Fishersville, VA 22939
Phone (540) 332-5687

70 Medical Center Cir
Ste 305
Fishersville, VA 22939
Phone (540) 245-5747

644 University Blvd
Harrisonburg, VA 22801
Phone (540) 564-5100

30 Greenhouse Rd
Lexington, VA 24450
Phone (540) 464-3465

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 4

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1891829693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229390388",
            "telephone_number": "540-932-5747",
            "fax_number": "540-932-5748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MEDICAL CENTER CIR STE 305",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392273",
            "telephone_number": "540-932-5747",
            "fax_number": "540-932-5748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2509 Pleasant Run Dr",
            "address_purpose": "LOCATION",
            "city": "Harrisonburg",
            "state": "VA",
            "postal_code": "228018720",
            "country_code": "US",
            "telephone_number": "540-689-4500",
            "fax_number": "757-579-8597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLEN",
        "first_name": "JUSTIN",
        "middle_name": "LEE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002178",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110002718",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891829693",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

Verify at the official NPI Registry.