Individual provider Active NPI

Maria Misseri, NP-C

  • Family Nurse Practitioner
  • Hopewell, VA
National Provider Identifier
1922622281
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024179405 Issued in VA
Practice address
1012 Winston Churchill Dr
Hopewell, VA 23860-5141
Phone
(804) 458-8583
Fax
(804) 541-2724
NPI assigned
Jun 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024179405 VA Primary

Addresses

Primary practice location

1012 Winston Churchill Dr
Hopewell, VA 23860-5141

Mailing address

4274 Newville Rd
Waverly, VA 23890-3720

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
I20200729003769 VA Practitioner - Nurse Practitioner 1254756869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Twin River Medical Clinic PCGroup PAC ID 7517923790, 8 clinicians

Practice addresses (Care Compare)

1012 Winston Churchill Dr
Hopewell, VA 23860-5141
Phone (804) 458-8583

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024179405VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Twin River Medical Clinic PC CurrentSince Jul 23, 2020 Accepting new patients

Locations

1012 Winston Churchill Dr
Hopewell, VA 23860
Phone (804) 458-8583

Interoperability endpoints

  • Direct secure messaging: twinriversmedicalclinic.mariamisseri@119949.advancedmd-direct.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1922622281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4274 NEWVILLE RD",
            "city": "WAVERLY",
            "state": "VA",
            "postal_code": "238903720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 WINSTON CHURCHILL DR",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238605141",
            "telephone_number": "804-458-8583",
            "fax_number": "804-541-2724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISSERI",
        "first_name": "MARIA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2020-10-01",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024179405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopewell, VA

Sources for this page

Verify at the official NPI Registry.