Individual provider Active NPI

Sonam Norbu, MS, RN, AG-ACNP

  • Acute Care Nurse Practitioner
  • Fairfax, VA
National Provider Identifier
1144674821
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R227564 Issued in MD
Practice address
4887 Wheatstone Dr
Fairfax, VA 22032-2341
Phone
(937) 474-3570
NPI assigned
Apr 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0024174624 VA
Acute Care Nurse Practitioner 363LA2100X R227564 MD Primary

Addresses

Primary practice location

4887 Wheatstone Dr
Fairfax, VA 22032-2341

Mailing address

4887 Wheatstone Dr
Fairfax, VA 22032-2341
Phone (937) 474-3570

Other practice location 1

1850 Town Center Pkwy
Reston, VA 20190-3204
Phone (240) 686-2300

Other identifiers 1

IdentifierTypeStateIssuer
1144674821MedicaidDC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sonam_norbu@optum.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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
I20170928000441 DC Practitioner - Nurse Practitioner 8224316948 Reassigns benefits to 2 organizations
I20190507002833 VA Practitioner - Nurse Practitioner 8224316948

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
R227564MDMDAcute Care Nurse Practitioner
0024174624VAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Sep 1, 2021 Accepting new patients
Fair Oaks Hospitalist Physicians, PLLC CurrentSince Jul 1, 2017 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Sep 1, 2021 Accepting new patients
Arnot Medical Services PLLC Past Accepting new patients

Locations

7600 Carroll Ave
Takoma Park, MD 20912
Phone (301) 791-7600

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

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

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

Organizations & group practices 4

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": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1144674821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4887 WHEATSTONE DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220322341",
            "telephone_number": "937-474-3570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4887 WHEATSTONE DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220322341",
            "telephone_number": "937-474-3570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1850 Town Center Pkwy",
            "address_purpose": "LOCATION",
            "city": "Reston",
            "state": "VA",
            "postal_code": "201903204",
            "country_code": "US",
            "telephone_number": "240-686-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORBU",
        "first_name": "SONAM",
        "name_prefix": "Mrs.",
        "credential": "MS, RN, AG-ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-19",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024174624",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R227564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144674821",
            "state": "DC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sonam_norbu@optum.com",
            "affiliation": "N",
            "address_1": "4887 Wheatstone Dr",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220322341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.