Individual provider Active NPI

Beverly J. Mirmelstein, N.P.

  • Nurse Practitioner
  • Fishersville, VA
National Provider Identifier
1922190438
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024043117 Issued in VA
Practice address
22 N Medical Park Dr
Fishersville, VA 22939-2344
Phone
(540) 932-5373
Fax
(540) 932-5382
NPI assigned
Sep 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0024043117 VA Primary

Addresses

Primary practice location

22 N Medical Park Dr
Fishersville, VA 22939-2344

Mailing address

500 Ray C Hunt Dr
Charlottesville, VA 22903-2981
Phone (434) 980-6140

Other identifiers 1

IdentifierTypeStateIssuer
007781440MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922190438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 RAY C HUNT DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229032981",
            "telephone_number": "434-980-6140",
            "fax_number": "434-972-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 N MEDICAL PARK DR",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392344",
            "telephone_number": "540-932-5373",
            "fax_number": "540-932-5382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRMELSTEIN",
        "first_name": "BEVERLY",
        "middle_name": "J.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024043117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007781440",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.