JESSIE SHORE NIELSEN PA-C NPI 1629717665

NPI Information

  • NPI: 1629717665
  • Provider Name: JESSIE SHORE NIELSEN, PA-C
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 6311 RICHMOND HWY
    ALEXANDRIA, VA
    ZIP 22306
  • Phone: (703) 647-6087

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NPI Details

Jessie Shore Nielsen, PA-C is a physician assistant in Alexandria, VA with 3 years of experience. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. Jessie Shore Nielsen, PA-C NPI is 1629717665. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6311 RICHMOND HWY
ALEXANDRIA, VA
ZIP 22306-410
Phone: (703) 647-6087

The NPI 1629717665 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Emergency department visit for life threatening or functioning severity (HCPCS:99285)
  • Emergency department visit for problem of high severity (HCPCS:99284)
  • Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only (HCPCS:93010)
  • Emergency department visit for problem of moderate severity (HCPCS:99283)

The enumeration date for this NPI number is 5/28/2022 and was last updated on 5/28/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician Assistant0110009969VIRGINIAYes
2363AM0700XPhysician AssistantMedicalPA200001493DISTRICT OF COLUMBIANo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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