Active NPI
Laura Leigh Wolok, R.D., C.D.E.
- Diabetes Educator Registered Nurse
- Fairfax, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diabetes Educator Registered Nurse
- License
- 20320510
- Practice address
- 2740 Prosperity Ave Ste 200
Fairfax, VA 22031-4354 - Phone
- (877) 511-4625
- Fax
- (703) 204-9006
- NPI assigned
- Jan 7, 2010
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | |||
| Diabetes Educator Registered Nurse | 163WD0400X | 20320510 | VA | Primary |
Addresses
Primary practice location
2740 Prosperity Ave Ste 200
Fairfax, VA 22031-4354
Mailing address
2740 Prosperity Ave Ste 200
Fairfax, VA 22031-4354
Phone (877) 511-4625
Other practice location 1
2700 Prosperity Ave Ste 100
Fairfax, VA 22031-4340
Phone (703) 698-2505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20320510 | VA | MD | Diabetes Educator Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inova Health Care Services | Current | Accepting new patients |
Locations
4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000
43490 Yukon Dr
Ste 204
Ashburn, VA 20147
Phone (571) 665-6960
2740 Prosperity Ave
Ste 200
Fairfax, VA 22031
Phone (703) 208-2273
2700 Prosperity Ave
Ste 100
Fairfax, VA 22031
Phone (703) 698-2505
3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395
224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602460800000",
"number": "1184954539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2740 PROSPERITY AVE STE 200",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220314354",
"telephone_number": "877-511-4625",
"fax_number": "703-204-9006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2740 PROSPERITY AVE STE 200",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220314354",
"telephone_number": "877-511-4625",
"fax_number": "703-204-9006"
}
],
"practiceLocations": [
{
"address_1": "2700 Prosperity Ave Ste 100",
"address_purpose": "LOCATION",
"city": "Fairfax",
"state": "VA",
"postal_code": "220314340",
"country_code": "US",
"telephone_number": "703-698-2505",
"fax_number": "703-698-2506",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOLOK",
"first_name": "LAURA",
"middle_name": "LEIGH",
"name_prefix": "Mrs.",
"credential": "R.D., C.D.E.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-07",
"last_updated": "2020-10-12",
"certification_date": "2020-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": false
},
{
"code": "163WD0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Diabetes Educator",
"state": "VA",
"license": "20320510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.