Organization Active NPI

Olgavarnachevallc

  • Nurse Practitioner
  • Gaithersburg, MD
National Provider Identifier
1114696309
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
OLGAVARNACHEVALLC
Practice address
204 Ridgepoint PL
Gaithersburg, MD 20878-5691
Phone
(832) 331-4862
NPI assigned
Sep 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Authorized official

Name
Olga Varnacheva, NPNPI 1952815771
Title
Owner
Phone
(832) 331-4862

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

204 Ridgepoint PL
Gaithersburg, MD 20878-5691

Mailing address

204 Ridgepoint PL
Gaithersburg, MD 20878-5691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210923002037 MD Part B Supplier - Clinic/Group Practice 3274930813 Receives reassigned benefits from 1 practitioner
Practice locations: Gaithersburg, MD
O20210927000198 DC Part B Supplier - Clinic/Group Practice 3274930813 Receives reassigned benefits from 1 practitioner
Practice locations: Gaithersburg, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631232000000",
    "number": "1114696309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 RIDGEPOINT PL",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208785691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 RIDGEPOINT PL",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208785691",
            "telephone_number": "832-331-4862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLGAVARNACHEVALLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A",
        "authorized_official_last_name": "VARNACHEVA",
        "authorized_official_first_name": "OLGA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-331-4862",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.