NPIMap

Individual provider Active NPI

Nicole Diane Walsh, PA

  • Physician Assistant
  • Newport News, VA
National Provider Identifier
1902575624
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110-008095 Issued in VA
Practice address
730 Thimble Shoals Blvd
Newport News, VA 23606-4562
Phone
(757) 873-1554
Fax
(757) 223-9564
NPI assigned
Sep 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110-008095 VA Primary

Addresses

Primary practice location

730 Thimble Shoals Blvd
Newport News, VA 23606-4562

Mailing address

730 Thimble Shoals Blvd Ste 130
Newport News, VA 23606-4562
Phone (757) 873-1554

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nicole.walsh@hrosm.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211014001361 VA Practitioner - Physician Assistant 5991103475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians

Practice addresses (Care Compare)

1401 N High St
Franklin, VA 23851-1244
Phone (757) 516-8130

730 Thimble Shoals Blvd
Suite 130
Newport News, VA 23606-4562
Phone (757) 873-1554

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110-008095VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hampton Roads Orthopaedic & Sports Medicine LLC CurrentSince Nov 27, 2023 Accepting new patients

Locations

730 Thimble Shoals Blvd
Ste 130
Newport News, VA 23606
Phone (757) 327-0103

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 12

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": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1902575624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 THIMBLE SHOALS BLVD STE 130",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064562",
            "telephone_number": "757-873-1554",
            "fax_number": "757-223-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 THIMBLE SHOALS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064562",
            "telephone_number": "757-873-1554",
            "fax_number": "757-223-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "NICOLE",
        "middle_name": "DIANE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-008095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicole.walsh@hrosm.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "730 Thimble Shoals Blvd",
            "city": "Newport News",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236064562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.