=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427736289
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JERIMIE CHRISTOPHER CAUDILL FNP-C
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2023
-----------------------------------------------------
Last Update Date | 12/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7101 JAHNKE RD STE 200
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23225-4017
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-806-6050
-----------------------------------------------------
Fax | 804-806-6051
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8710 N FIVE FORKS RD
-----------------------------------------------------
City | AMELIA COURT HOUSE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23002-4846
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-305-1850
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | F07230354
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------