Individual provider Active NPI

Hartley Wenger

  • Clinical Nurse Specialist
  • Falls Church, VA
National Provider Identifier
1003666975
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
0024182029 Issued in VA
Practice address
3300 Gallows Rd
Falls Church, VA 22042-3307
Phone
(703) 776-7805
NPI assigned
Mar 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 0024182029 VA Primary

Addresses

Primary practice location

3300 Gallows Rd
Falls Church, VA 22042-3307

Mailing address

9107 John Way
Fairfax Station, VA 22039-3043
Phone (631) 834-7955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0024182029VAMDClinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1003666975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9107 JOHN WAY",
            "city": "FAIRFAX STATION",
            "state": "VA",
            "postal_code": "220393043",
            "telephone_number": "631-834-7955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307",
            "telephone_number": "703-776-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGER",
        "first_name": "HARTLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "VA",
            "license": "0024182029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.