Individual provider Active NPI

Pamela A Crippen

  • Adult Health Nurse Practitioner
  • Falls Church, VA
National Provider Identifier
1063481406
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0024085478 Issued in VA
Practice address
2921 Telestar CT
Suite 140
Falls Church, VA 22042-1205
Phone
(703) 280-5858
Fax
(703) 280-2654
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0024085478 VA Primary

Addresses

Primary practice location

2921 Telestar CT
Suite 140
Falls Church, VA 22042-1205

Mailing address

2921 Telestar CT
Suite 140
Falls Church, VA 22042-1205
Phone (703) 280-5858

Other identifiers 2

IdentifierTypeStateIssuer
010148545MedicaidVA
407359200MedicaidMD

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024085478VAMDAdult Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: pcrippen24601@soc.inova.org

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1063481406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 TELESTAR CT",
            "address_2": "SUITE 140",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220421205",
            "telephone_number": "703-280-5858",
            "fax_number": "703-280-2654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 TELESTAR CT",
            "address_2": "SUITE 140",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220421205",
            "telephone_number": "703-280-5858",
            "fax_number": "703-280-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIPPEN",
        "first_name": "PAMELA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024085478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010148545",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "407359200",
            "state": "MD"
        }
    ],
    "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 Feb 16, 2010; 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.