Aeden Ghebreselassie, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024174118 Issued in VA

Practice address

1680 Capital One Dr
MC Lean, VA 22102-3407

Phone

(703) 720-1290

Fax

(703) 720-1291

NPI assigned

Dec 17, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Premise Health of Virginia Medical PC

  • Urgent Care Clinic/Center
  • MC Lean, VA
  • NPI 1992148241
  NPD (past)

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1093051237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 CAPITAL ONE DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023407",
            "telephone_number": "703-720-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 CAPITAL ONE DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023407",
            "telephone_number": "703-720-1290",
            "fax_number": "703-720-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHEBRESELASSIE",
        "first_name": "AEDEN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-17",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geo Healthcare LLC
• Megan F Gerbracht, PSY.D.
• Lauren Poppalardo Geriak, MA, LPC
• Germain Plastic Surgery PLLC
• Mae-Lynn Germany
• Richa Ghimire, RBT
• Richard Paul Giannotto, MD
• Danielle Gibbens, DNP, FNP-C
• Lynda Gibbs, F.N.P.
• Delaney Erin Gilfoyle, LMSW

• Family Nurse Practitioner in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.