NPIMap

Individual provider Active NPI

Lauren Ann Stoeckmann, PA-C

  • Physician Assistant
  • Suffolk, VA
National Provider Identifier
1912560012
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110006941 Issued in VA
Practice address
1030 Champions Way
Suffolk, VA 23435-3914
Phone
(757) 673-6118
Fax
(757) 967-9003
NPI assigned
Apr 15, 2019
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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 9112029 FL
Physician Assistant 363A00000X 0110006941 VA Primary

Addresses

Primary practice location

1030 Champions Way
Suffolk, VA 23435-3914

Mailing address

860 Omni Blvd Ste 101
Newport News, VA 23606-4430
Phone (757) 232-8769

Other names 1

  • Lauren Vandevelde Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, AK, TX3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200616000605 VA Practitioner - Physician Assistant 4981947199 Reassigns benefits to 1 organization
I20230331001586 AK Practitioner - Physician Assistant 4981947199 Reassigns benefits to 1 organization
I20260106000249 TX Practitioner - Physician Assistant 4981947199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3801 University Lake Dr
Anchorage, AK 99508-4658
Phone (907) 563-2662

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9112029FLMDPhysician Assistant
0110006941VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince May 1, 2020 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Dec 1, 2025 Accepting new patients
Alaska Medical Clinics, LLC Past Accepting new patients
Alaska Urgent Care, LLC Past Accepting new patients

Locations

3801 University Lake Dr
Anchorage, AK 99508
Phone (907) 563-8876

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

101 York Crossing Rd
#A
Grafton, VA 23692
Phone (757) 898-7737

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

827 Diligence Dr
Ste 100
Newport News, VA 23606

860 Omni Blvd
Ste 101
Newport News, VA 23606
Phone (757) 223-9794

1030 Champions Way
Suffolk, VA 23435
Phone (757) 673-6118

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1912560012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD STE 101",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064430",
            "telephone_number": "757-232-8769",
            "fax_number": "757-232-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 CHAMPIONS WAY",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353914",
            "telephone_number": "757-673-6118",
            "fax_number": "757-967-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOECKMANN",
        "first_name": "LAUREN",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9112029",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "VANDEVELDE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.