MEDICARE: NICOLE C RANKINS MD

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VM0101X	Maternal & Fetal Medicine Physician	0101243030	VA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PAR	OTHER	VA	FIRST HEALTH COMMERCIAL
2	PAR	OTHER	VA	USA MANAGED CARE
3	PAR	OTHER	VA	CORVEL/CORCARE
4	PAR	OTHER	VA	MULTIPLAN
5	350790	OTHER	VA	ANTHEM
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	PAR	OTHER	VA	VA PREMIER HEALTH
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	10032467	OTHER	VA	SENTARA/OPTIMA
10	2720919	OTHER	VA	CIGNA
11	3179017	OTHER	VA	UHC/MAMSI
12	7145814	OTHER	VA	AETNA
13	-010	OTHER	VA	TRICARE/CHAMPUS
14	PAR	OTHER	VA	VA HEALTH NETWORK
15	04274	OTHER	NC	NC BC/BS

NPI Number	:	1598706806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE C RANKINS MD

Provider Business Mailing Address
First Line	:	PO BOX 7650
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23231-0150
Country	:	US
Telephone Number	:	804-507-1644
Fax Number	:	804-507-0116

Provider Business Practice Location Address
First Line	:	1603 SKIPWITH RD
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23229-5253
Country	:	US
Telephone Number	:	804-507-1644
Fax Number	:	804-507-0116

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	09/22/2015