Individual provider Active NPI

Kathleen M Waters-Larocque, WHNP

  • Nurse Practitioner
  • Chesapeake, VA
National Provider Identifier
1912915281
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024137298 Issued in VA
Practice address
300 Medical Pkwy
Suite 300
Chesapeake, VA 23320-4985
Phone
(757) 548-3880
Fax
(757) 548-3323
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024137298 VA Primary

Addresses

Primary practice location

300 Medical Pkwy
Suite 300
Chesapeake, VA 23320-4985

Mailing address

300 Medical Pkwy
Suite 300
Chesapeake, VA 23320-4985
Phone (757) 548-3880

Other identifiers 1

IdentifierTypeStateIssuer
010037158MedicaidVA

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
I20130618000137 VA Practitioner - Nurse Practitioner 6901045293 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024137298VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Womens Care PLC CurrentSince Jul 23, 2021 Accepting new patients
Atlantic Obstetrics & Gynocology PastSince Nov 1, 2014 Accepting new patients

Locations

676 Battlefield Blvd N
Ste A
Chesapeake, VA 23320
Phone (757) 420-0566

300 Medical Pkwy
Ste 200
Chesapeake, VA 23320
Phone (757) 625-4455

101 Eaton St
Ste 300
Hampton, VA 23669
Phone (757) 874-2229

12706 McManus Blvd
Newport News, VA 23602
Phone (757) 874-2229

844 Kempsville Rd
Ste 208
Norfolk, VA 23502
Phone (757) 461-3890

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5623/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1912915281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PKWY",
            "address_2": "SUITE 300",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204985",
            "telephone_number": "757-548-3880",
            "fax_number": "757-548-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PKWY",
            "address_2": "SUITE 300",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204985",
            "telephone_number": "757-548-3880",
            "fax_number": "757-548-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS-LAROCQUE",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024137298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010037158",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.