Individual provider Active NPI

Susan G Magenheimer, CNM

  • Midwife
  • Leesburg, VA
National Provider Identifier
1154614048
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
0024165070 Issued in VA
Practice address
19455 Deerfield Avenue, Suite 204
Leesburg, VA 20176-8102
Phone
(703) 858-1500
Fax
(703) 858-5022
NPI assigned
May 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X RN1022120 DC
Midwife 176B00000X 0024165070 VA Primary

Addresses

Primary practice location

19455 Deerfield Avenue, Suite 204
Leesburg, VA 20176-8102

Mailing address

224-D Cornwall Street, NW, Suite 403
Leesburg, VA 20176-2704
Phone (703) 737-6010

Other identifiers 2

IdentifierTypeStateIssuer
1154614048MedicaidVA
30016809680001MedicaidVA

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170605002652 VA Practitioner - Certified Nurse Midwife (CNM) 2769630342 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.65 of 100Reported as apm
Quality
85.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Medical Group, PC CurrentSince Dec 2, 2019 Accepting new patients
DHP of Virginia PC CurrentSince Jan 15, 2017 Accepting new patients
Loudoun Medical Group, PC CurrentSince Dec 2, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Fredericksburg OBGYN Center Inc Past Accepting new patients

Locations

20955 Professional Plz
Ste 200
Ashburn, VA 20147
Phone (703) 729-7652

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

224D Cornwall St NW
Ste 403
Leesburg, VA 20176
Phone (703) 737-6001

44055 Riverside Pkwy
Ste 234
Leesburg, VA 20176
Phone (703) 858-3020

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

17336 Pickwick Dr
Ste A
Purcellville, VA 20132
Phone (540) 338-3360

21135 Whitfield Pl
Ste 107
Sterling, VA 20165
Phone (703) 421-7000

Interoperability endpoints

  • Direct secure messaging: susan.magenheimer@lmg1.eclinicaldirectplus.com

Organizations & group practices 6

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": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1154614048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224-D CORNWALL STREET, NW, SUITE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19455 DEERFIELD AVENUE, SUITE 204",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201768102",
            "telephone_number": "703-858-1500",
            "fax_number": "703-858-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGENHEIMER",
        "first_name": "SUSAN",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "DC",
            "license": "RN1022120",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "VA",
            "license": "0024165070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154614048",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30016809680001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.