Individual provider Active NPI

Agea Challa Temesgen

  • Family Nurse Practitioner
  • Manassas, VA
National Provider Identifier
1043931694
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024184934 Issued in VA
Practice address
9715 Liberia Ave
Manassas, VA 20110-5837
Phone
(571) 229-1797
NPI assigned
Sep 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024184934 VA Primary

Addresses

Primary practice location

9715 Liberia Ave
Manassas, VA 20110-5837

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 822-4355

Other practice location 1

11840 Coloriver Rd
Manassas, VA 20112-8603
Phone (703) 624-7383

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address VAExchange@patientfirstclinics.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221130000591 VA Practitioner - Nurse Practitioner 1153799887 Reassigns benefits to 1 organization
I20221130003616 DC Practitioner - Nurse Practitioner 1153799887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patient First Richmond Medical Group PLLCGroup PAC ID 9931011434, 315 clinicians

Practice addresses (Care Compare)

2199 Old Bridge Rd
Woodbridge, VA 22192-2911
Phone (703) 357-9707

3031 Plank Rd
Fredericksburg, VA 22401-4951
Phone (540) 736-5043

60 Prosperity LN
Stafford, VA 22556-4605
Phone (540) 658-2811

601 Potomac Station Dr
Leesburg, VA 20176-1816
Phone (703) 840-1396

6311 Richmond Hwy
Alexandria, VA 22306-6410
Phone (703) 647-6087

9715 Liberia Ave
Manassas, VA 20110-5837
Phone (571) 229-1797

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024184934VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Richmond Medical Group PLLC CurrentSince Aug 31, 2022 Accepting new patients
Patient First Richmond Medical Group PLLC CurrentSince Aug 31, 2022 Accepting new patients

Locations

6311 Richmond Hwy
Alexandria, VA 22306
Phone (703) 647-6087

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

601 Potomac Station Dr NE
Leesburg, VA 20176
Phone (703) 840-1396

9715 Liberia Ave
Manassas, VA 20110
Phone (571) 229-1797

Interoperability endpoints

  • Direct secure messaging: vaexchange@patientfirstclinics.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1043931694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-822-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9715 LIBERIA AVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201105837",
            "telephone_number": "571-229-1797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11840 Coloriver Rd",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201128603",
            "country_code": "US",
            "telephone_number": "703-624-7383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEMESGEN",
        "first_name": "AGEA",
        "middle_name": "CHALLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024184934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "9715 Liberia Ave",
            "city": "Manassas",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201105837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.