Phanta Jah

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

0024182355 Issued in VA

Practice address

2833 Cleave Dr.
Falls Church, VA 22042

Phone

(800) 969-1104

NPI assigned

Aug 1, 2021

Last updated

Aug 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ennoble HC DMV LLCGroup PAC ID 9032517925, 112 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayada Home Health Care Inc Home health agency, Sterling, VA, CCN 497802
• Bayada Home Health Care Inc Home health agency, Falls Church, VA, CCN 497730
• Prospect Homecare Agency Home health agency, Fairfax, VA, CCN 497719

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Forever Caring Wellness & Learning Center

  • Primary Care Nurse Practitioner
  • Stafford, VA
  • NPI 1396613022
  Medicare reassignment NPD Authorized official
• Ennoble HC DMV LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Fulton, MD
  • NPI 1104492115

  DC, VA

  Medicare reassignment Care Compare group NPD
• Rahel G. Yirga MD PC

  • Internal Medicine Physician
  • Sterling, VA
  • NPI 1558508184

  DC

  Medicare reassignment NPD
• Ennoble HC DMV II LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Silver Spring, MD
  • NPI 1134002900

  DC, VA

  Medicare reassignment NPD
• Ennoble HC DMV III LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Silver Spring, MD
  • NPI 1922981695

  DC, VA

  Medicare reassignment NPD
• Virginia Recovery Living Corporation

  • Adult Health Nurse Practitioner
  • Woodbridge, VA
  • NPI 1528915998
  NPD Authorized official
• Ennoble HC NJ PC

  • Geriatric Medicine (Family Medicine) Physician
  • Hackensack, NJ
  • NPI 1306500764
  NPD (past)

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

• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Sterling, VA
  • NPI 1174246359
  Care Compare affiliation
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Falls Church, VA
  • NPI 1528435781
  Care Compare affiliation
• Prospect Homecare Agency

  • Home Health Agency
  • Fairfax, VA
  • NPI 1730582107
  Care Compare affiliation

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

{
    "created_epoch": "1627776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1174296461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2833 CLEAVE DR.",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220421837",
            "telephone_number": "180-096-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2833 CLEAVE DR.",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22042",
            "telephone_number": "800-969-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAH",
        "first_name": "PHANTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-01",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VA",
            "license": "0024182355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Renee Jacobs, HIS
• Kathryn Jacques
• Jade and Jasmine Healing Arts LLC
• Tanya Jadhav
• Jennifer Marie Jafari
• Pankaj Jain
• Paul Jajan
• Samara Jalala
• Deborah Jaldin
• Hamid Reza Jalili, MD

• Primary Care Nurse Practitioner in Falls Church, VA
• Providers in Falls Church, VA by specialty
• Primary Care Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.