Individual provider Active NPI

Emily T Keenan, CRNP-F

  • Family Nurse Practitioner
  • Winchester, VA
National Provider Identifier
1154476612
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024168786 Issued in VA
Practice address
2281 Valley Ave
Winchester, VA 22601-2755
Phone
(703) 229-5453
Fax
(888) 352-8653
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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 0024168786 VA Primary

Addresses

Primary practice location

2281 Valley Ave
Winchester, VA 22601-2755

Mailing address

11713 Wolf Run LN
Clifton, VA 20124-2222
Phone (703) 830-7926

Other identifiers 3

IdentifierTypeStateIssuer
400703400MedicaidMD
C0410037OtherDCCAREFIRST OF DC
88225501OtherMDCAREFIRST OF MARYLAND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160510001250 VA Practitioner - Nurse Practitioner 6608886601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vamed Health Group LLCGroup PAC ID 2668852120, 3 clinicians

Practice addresses (Care Compare)

2281 Valley Ave
Winchester, VA 22601-2755
Phone (540) 215-2211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024168786VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vamed Health Group LLC CurrentSince May 1, 2022 Accepting new patients
Professional Management Services, LLC Past Accepting new patients
Glenn G. Marinelli MD PA Past Accepting new patients
J Richard Lilly MD Shaaron R Towns MD and Associates PC Past Accepting new patients
Calvert Health Ventures Inc Past Accepting new patients

Locations

6138 Redwood Square Ctr
Ste 204
Centreville, VA 20121
Phone (703) 229-5453

2281 Valley Ave
Winchester, VA 22601
Phone (540) 215-2211

Organizations & group practices 5

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1154476612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11713 WOLF RUN LN",
            "city": "CLIFTON",
            "state": "VA",
            "postal_code": "201242222",
            "telephone_number": "703-830-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2281 VALLEY AVE",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012755",
            "telephone_number": "703-229-5453",
            "fax_number": "888-352-8653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "EMILY",
        "middle_name": "T",
        "credential": "CRNP-F",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024168786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400703400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST OF DC",
            "identifier": "C0410037",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST OF MARYLAND",
            "identifier": "88225501",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.