Active NPI
Nicole L Hartvigsen, M.D.
- Pediatrics Physician
- Falls Church, VA
National Provider Identifier
1184680241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2005007054
- Practice address
- 407 N. Washington Street
Ste. 100
Falls Church, VA 22046 - Phone
- (703) 237-5919
- Fax
- (703) 241-1863
- NPI assigned
- Apr 25, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2005007054 | MO | Primary |
| Pediatrics Physician | 208000000X | 04-31628 | KS |
Addresses
Primary practice location
407 N. Washington Street
Ste. 100
Falls Church, VA 22046
Mailing address
407 N. Washington Street
Ste. 100
Falls Church, VA 22046
Phone (703) 237-5919
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200332820A | Medicaid | KS | |
| 207198904 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-31628 | KS | MD | Pediatrics Physician |
| 2005007054 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Clinic, P.a. | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DEDCAA/Endpoint/DEDCAA
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.
-
- Pediatrics Physician
- Los Alamos, NM
- NPI 1679793277
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326844800000",
"number": "1184680241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 N. WASHINGTON STREET",
"address_2": "STE. 100",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "22046",
"telephone_number": "703-237-5919",
"fax_number": "703-241-1863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 N. WASHINGTON STREET",
"address_2": "STE. 100",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "22046",
"telephone_number": "703-237-5919",
"fax_number": "703-241-1863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTVIGSEN",
"first_name": "NICOLE",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-25",
"last_updated": "2012-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2005007054",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KS",
"license": "04-31628",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200332820A",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "207198904",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Falls Church, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.