Individual provider Active NPI

Sarian Beverly Wilson, NP-C

  • Nurse Practitioner
  • Waldorf, MD
National Provider Identifier
1154960128
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F11190605 Issued in MD
Practice address
2203 Kayhill Dr
Waldorf, MD 20601
Phone
(703) 582-0452
NPI assigned
Dec 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F11190605 MD Primary

Addresses

Primary practice location

2203 Kayhill Dr
Waldorf, MD 20601

Mailing address

2203 Kayhill Dr
Waldorf, MD 20601
Phone (703) 582-0452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20211115002844 DC Practitioner - Nurse Practitioner 1759545387 Reassigns benefits to 1 organization
I20230928004050 MD Practitioner - Nurse Practitioner 1759545387 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Care Center LLCGroup PAC ID 3274801139, 286 clinicians

Practice addresses (Care Compare)

110 Baughmans LN
Suite 140
Frederick, MD 21702-4649
Phone (240) 215-1138

12070 Old Line Ctr
Suite 302
Waldorf, MD 20602-2567
Phone (301) 843-7667

Hospital & facility affiliations

  • Chesapeake - Potomac Home Health Agency, Inc. Home health agency, Hughesville, MD, CCN 217138
  • Medstar Health Home Care Home health agency, Hyattsville, MD, CCN 217150

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F11190605MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
Metrospine PC CurrentSince Nov 1, 2021 Accepting new patients
Privia Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
Menocal Medical Services PA Current Accepting new patients
Privia Care Center LLC CurrentSince Sep 1, 2023 Accepting new patients
Privia Care Center LLC CurrentSince Sep 1, 2023 Accepting new patients
Metrospine PC CurrentSince Nov 1, 2021 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

301 Saint Paul St
Ste 409
Baltimore, MD 21202
Phone (410) 659-7041

9001 Woodyard Rd
Ste A
Clinton, MD 20735
Phone (301) 856-5860

110 Baughmans Ln
Ste 140
Frederick, MD 21702
Phone (240) 215-1138

6188 Oxon Hill Rd
Ste 180
Oxon Hill, MD 20745

6188 Oxon Hill Rd
Ste 100
Oxon Hill, MD 20745
Phone (301) 567-2100

6196 Oxon Hill Rd
Ste 510
Oxon Hill, MD 20745
Phone (301) 567-7877

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

12070 Old Line Ctr
Ste 302
Waldorf, MD 20602
Phone (301) 645-6667

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: sarian.wilson.1@8042.direct.athenahealth.com

Organizations & group practices 9

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1154960128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 KAYHILL DR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "20601",
            "telephone_number": "703-582-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 KAYHILL DR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "20601",
            "telephone_number": "703-582-0452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SARIAN",
        "middle_name": "BEVERLY",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-23",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "F11190605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.