Individual provider Active NPI

Barnett G Mennen, M.D.

  • Family Medicine Physician
  • Vienna, VA
National Provider Identifier
1184848004
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0072173 Issued in MD
Practice address
1880 Howard Ave
Suite 300
Vienna, VA 22182-2667
Phone
(703) 790-0103
Fax
(790) 703-0379
NPI assigned
Apr 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0072173 MD Primary
Pediatrics Physician 208000000X D0072173 MD

Addresses

Primary practice location

1880 Howard Ave
Suite 300
Vienna, VA 22182-2667

Mailing address

1880 Howard Ave
Suite 300
Vienna, VA 22182-2667
Phone (703) 790-0103

Other identifiers 2

IdentifierTypeStateIssuer
D0072173OtherMDSTATE LICENSE
0101248289OtherVASTATE LICENSE

Other names 1

  • Dr. Barry G Mennen Other name

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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160622000154 DC Practitioner - Family Practice 3072837434 Reassigns benefits to 2 organizations
I20171127002273 MD Practitioner - Pediatric Medicine 3072837434 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Healthcare PC CurrentSince Jun 10, 2017 Accepting new patients
Privia Medical Group, LLC Family Medicine CurrentSince May 31, 2016 Accepting new patients
Privia Medical Group, LLC CurrentSince May 31, 2016 Accepting new patients

Locations

8305 Wisconsin Ave
Bethesda, MD 20814
Phone (301) 800-7000

8205 Snowden River Pkwy
Columbia, MD 21045
Phone (410) 290-9990

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

6020 Richmond Hwy
Ste 102
Alexandria, VA 22303
Phone (267) 978-1993

Organizations & group practices 3

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1184848004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 HOWARD AVE",
            "address_2": "SUITE 300",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822667",
            "telephone_number": "703-790-0103",
            "fax_number": "703-790-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 HOWARD AVE",
            "address_2": "SUITE 300",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822667",
            "telephone_number": "703-790-0103",
            "fax_number": "790-703-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENNEN",
        "first_name": "BARNETT",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0072173",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0072173",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "D0072173",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0101248289",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BARRY",
            "last_name": "MENNEN",
            "middle_name": "G",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vienna, VA

Sources for this page

Verify at the official NPI Registry.