Individual provider Active NPI

Lekeithia Wilkes

  • Family Nurse Practitioner
  • Fairfax, VA
National Provider Identifier
1083089031
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024173032 Issued in VA
Practice address
10580 Arrowhead Dr
Fairfax, VA 22030
Phone
(571) 432-2600
NPI assigned
Dec 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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 0024173032 VA Primary

Addresses

Primary practice location

10580 Arrowhead Dr
Fairfax, VA 22030

Mailing address

11331 Edenderry Dr
Fairfax, VA 22030-5406
Phone (706) 267-2346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024173032VAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1083089031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11331 EDENDERRY DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305406",
            "telephone_number": "706-267-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10580 ARROWHEAD DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "571-432-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKES",
        "first_name": "LEKEITHIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-02",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.