Organization Active NPI

Trinity Family Practice LLC

  • Family Nurse Practitioner
  • Centreville, VA
National Provider Identifier
1144955261
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
TRINITY FAMILY PRACTICE LLC
Practice address
14260R Centreville SQ
Centreville, VA 20121-2364
Phone
(571) 361-7881
NPI assigned
Jul 21, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Blessy Sebastian, DNPNPI 1548715261
Title
Owner of Entity
Phone
(571) 361-7881

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
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

14260R Centreville SQ
Centreville, VA 20121-2364

Mailing address

14260R Centreville SQ
Centreville, VA 20121-2364
Phone (571) 361-7881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220824001264 DC Part B Supplier - Clinic/Group Practice 2466835426 Receives reassigned benefits from 2 practitioners
Practice locations: Centreville, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2286788Trinity Family Practice14260R Centreville SQ, Centreville, VA 20121Certificate of waiverAug 2, 2027

National Provider Directory

National Provider Directory

Locations

14260R Centreville Sq
Centreville, VA 20121
Phone (571) 361-7881

Practitioners & affiliated clinicians

Practitioners 2

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": "1658361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1144955261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14260R CENTREVILLE SQ",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212364",
            "telephone_number": "571-361-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14260R CENTREVILLE SQ",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212364",
            "telephone_number": "571-361-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SEBASTIAN",
        "authorized_official_first_name": "BLESSY",
        "authorized_official_title_or_position": "OWNER OF ENTITY",
        "authorized_official_telephone_number": "571-361-7881",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.