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NICHOLAS FANSELOW
NPI 1003675109
General Practice in Portsmouth, VA

Active since March 19, 2024
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708(757) 953-0669 Get Directions Write a Review

NPPES record last updated: September 26, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Nicholas Fanselow NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICHOLAS FANSELOW (NPI 1003675109) is an individual general practice provider in Portsmouth, Virginia, licensed in Virginia (0101286704) and active in the NPI registry since March 2024.

NPPES Registry Identity

NPI1003675109
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameNICHOLAS FANSELOW
Location Address620 JOHN PAUL JONES CIRPortsmouth, VA 23708-2111
Mailing Address620 John Paul Jones CirPortsmouth, VA 23708-2111 · (757) 953-0669
Phone(757) 953-0669
Sole ProprietorNo
Enumeration DateMarch 19, 2024
Last NPPES UpdateSeptember 26, 2025
NPPES CertifiedSeptember 26, 2025
✔ NPI 1003675109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in VA · 0101286704
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedMilitary Health Care ProviderTaxonomy 171000000X
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
620 JOHN PAUL JONES CIR, Portsmouth, VA 23708
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEREDITH TVERDOSI CRNA
Nurse Anesthetist, Certified Registered
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-3238
ERIC FRANCIS SULAVA
Emergency Medicine
620 JOHN PAUL JONES CIR, NAVAL MEDICAL CENTER PORTSMOUTH
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-0669
MRS. TIFFNY KUPER RHH
Dental Hygienist
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-2711
DR. LAKEISHA GOODE PHARMD
Pharmacist
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-7462
JASMINE WOOD MD
Surgery
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-1895
DR. DAVID JESSEN MD
Military Health Care Provider
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-2518
MRS. WILLAR MAE BAUM L.C.S.W.
Social Worker (Clinical)
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-9767
DR. DANIEL VERNON UNGER M.D.
Orthopaedic Surgery
620 JOHN PAUL JONES CIR, NAVAL MEDICAL CENTER
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-1888

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicholas Fanselow's NPI number?

The NPI number for Nicholas Fanselow is 1003675109. It was assigned to this individual provider in the NPPES registry on March 19, 2024.

Where is Nicholas Fanselow located?

Nicholas Fanselow practices at 620 John Paul Jones Cir, Portsmouth, VA 23708. The listed phone number is (757) 953-0669.

What is Nicholas Fanselow's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Nicholas Fanselow was last updated on September 26, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.