Active NPI
Liliana Manrique
- Internal Medicine Physician
- MC Lean, VA
National Provider Identifier
1073917027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0101258925
- Practice address
- 1300 Chain Bridge Rd
MC Lean, VA 22101-3935 - Phone
- (703) 790-5454
- Fax
- (202) 966-0940
- NPI assigned
- Oct 20, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101258925 | VA | Primary |
Addresses
Primary practice location
1300 Chain Bridge Rd
MC Lean, VA 22101-3935
Mailing address
5326 43Rd St NW
Washington, DC 20015-2008
Phone (202) 841-2960
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0101258925 | VA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441843200000",
"number": "1073917027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5326 43RD ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200152008",
"telephone_number": "202-841-2960",
"fax_number": "202-966-0940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 CHAIN BRIDGE RD",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221013935",
"telephone_number": "703-790-5454",
"fax_number": "202-966-0940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANRIQUE",
"first_name": "LILIANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-20",
"last_updated": "2015-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101258925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in MC Lean, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.