Individual provider Active NPI

Amanda Leigh Kern, CRNA

  • Certified Registered Nurse Anesthetist
  • Arlington, VA
National Provider Identifier
1053604470
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024169467 Issued in VA
Practice address
1635 N George Mason Dr Ste 2D
Arlington, VA 22205-3601
Phone
(703) 558-6173
NPI assigned
May 18, 2011
Last updated
Dec 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001185515 VA
Certified Registered Nurse Anesthetist 367500000X 0024169467 VA Primary

Addresses

Primary practice location

1635 N George Mason Dr Ste 2D
Arlington, VA 22205-3601

Mailing address

16 Linden Hill Way SW
Leesburg, VA 20175-5030
Phone (202) 368-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110809000296 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113196122 Reassigns benefits to 1 organization
I20210311001875 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113196122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Cares - CommunityGroup PAC ID 9537526330, 187 clinicians

Practice addresses (Care Compare)

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

44035 Riverside Pkwy
Suite 200
Leesburg, VA 20176-8260
Phone (571) 209-6465

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001185515VAMDRegistered Nurse
0024169467VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Cares - Community CurrentSince Aug 13, 2024 Accepting new patients

Locations

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

44035 Riverside Pkwy
Ste 200
Leesburg, VA 20176
Phone (571) 209-6465

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

Organizations & group practices 1

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1053604470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 LINDEN HILL WAY SW",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201755030",
            "telephone_number": "202-368-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 N GEORGE MASON DR STE 2D",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222053601",
            "telephone_number": "703-558-6173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERN",
        "first_name": "AMANDA",
        "middle_name": "LEIGH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-18",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001185515",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024169467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.