Active NPI
Catherine Anne Thal-Larsen, F.N.P.
- Family Nurse Practitioner
- Gainesville, VA
National Provider Identifier
1174774871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 0017000751
- Practice address
- 14535 John Marshall Hwy, Suite 212,
Gainesville, VA 20155-4025 - Phone
- (571) 248-0245
- Fax
- (571) 248-0241
- NPI assigned
- Oct 1, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0017000751 | VA | Primary |
Addresses
Primary practice location
14535 John Marshall Hwy, Suite 212,
Gainesville, VA 20155-4025
Mailing address
224 D Cornwall Street NW
Ste 403
Leesburg, VA 20176-2704
Phone (703) 737-6010
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174774871 | Medicaid | VA | |
| 30017620550001 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0017000751 | VA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Loudoun Medical Group, PC | Current | Accepting new patients |
Locations
6355 Walker Ln
Ste 308
Alexandria, VA 22310
Phone (703) 313-7700
224D Cornwall St NW
Ste 403
Leesburg, VA 20176
Phone (703) 737-6001
Organizations & group practices 1
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.
-
- Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
- Reston, VA
- NPI 1407908817
DC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710806400000",
"number": "1174774871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 D CORNWALL STREET NW",
"address_2": "STE 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": "14535 JOHN MARSHALL HWY, SUITE 212,",
"city": "GAINESVILLE",
"state": "VA",
"postal_code": "201554025",
"telephone_number": "571-248-0245",
"fax_number": "571-248-0241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAL-LARSEN",
"first_name": "CATHERINE",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"credential": "F.N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-01",
"last_updated": "2024-03-19",
"certification_date": "2024-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "VA",
"license": "0017000751",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1174774871",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30017620550001",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gainesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.