Individual provider Active NPI

Wanda A Isdell, CRNAP

  • Certified Registered Nurse Anesthetist
  • Nassawadox, VA
National Provider Identifier
1003976770
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0001066207 Issued in VA
Practice address
9507 Hospital Avenue
Nassawadox, VA 23413
Phone
(757) 414-8000
NPI assigned
Dec 11, 2006
Last updated
Feb 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0001066207 VA Primary

Addresses

Primary practice location

9507 Hospital Avenue
Nassawadox, VA 23413

Mailing address

3998 Fair Ridge Dr
Ste 300
Fairfax, VA 22033-2907
Phone (703) 295-9360

Other identifiers 2

IdentifierTypeStateIssuer
C00228OtherVAMEDICARE ID NUMBER
CA5831OtherVARAILROAD MEDICARE PART B

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001066207VAMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1003976770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE DR",
            "address_2": "STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332907",
            "telephone_number": "703-295-9360",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9507 HOSPITAL AVENUE",
            "city": "NASSAWADOX",
            "state": "VA",
            "postal_code": "23413",
            "telephone_number": "757-414-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISDELL",
        "first_name": "WANDA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "CRNAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0001066207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID NUMBER",
            "identifier": "C00228",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PART B",
            "identifier": "CA5831",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nassawadox, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.