Individual provider Active NPI

Rosemary Nzeogu, CNP

  • Family Nurse Practitioner
  • Manassas, VA
National Provider Identifier
1124316435
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0017141155 Issued in VA
Practice address
6360 Hoadly Rd
Manassas, VA 20112-3422
Phone
(703) 897-4961
Fax
(703) 583-4574
NPI assigned
Jul 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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 0017141155 VA Primary

Addresses

Primary practice location

6360 Hoadly Rd
Manassas, VA 20112-3422

Mailing address

11610 Fairfax Meadows Cir
Apt. 18201
Fairfax, VA 22030-8376
Phone (614) 648-9525

Other identifiers 1

IdentifierTypeStateIssuer
4894080MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140507000048 VA Practitioner - Nurse Practitioner 0345336327 Reassigns benefits to 1 organization
I20140508000484 DC Practitioner - Nurse Practitioner 0345336327 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0017141155VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jun 20, 2016 Accepting new patients
River Crossing Health Inc PastSince Mar 1, 2016 Accepting new patients

Locations

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1124316435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11610 FAIRFAX MEADOWS CIR",
            "address_2": "APT. 18201",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220308376",
            "telephone_number": "614-648-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 HOADLY RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201123422",
            "telephone_number": "703-897-4961",
            "fax_number": "703-583-4574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NZEOGU",
        "first_name": "ROSEMARY",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-20",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0017141155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4894080",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.