Active NPI
Maryann Valcourt, CPNP-BC
- Pediatric Nurse Practitioner
- Burke, VA
National Provider Identifier
1194355388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 0024164946
- Practice address
- 8988 Fern Park Dr
Burke, VA 22015-1635 - Phone
- (703) 978-6061
- Fax
- (703) 978-0291
- NPI assigned
- Jan 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 0024164946 | VA | Primary |
Addresses
Primary practice location
8988 Fern Park Dr
Burke, VA 22015-1635
Mailing address
8988 Fern Park Dr
Burke, VA 22015-1635
Phone (703) 978-6061
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024164946 | VA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579132800000",
"number": "1194355388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8988 FERN PARK DR",
"city": "BURKE",
"state": "VA",
"postal_code": "220151635",
"telephone_number": "703-978-6061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8988 FERN PARK DR",
"city": "BURKE",
"state": "VA",
"postal_code": "220151635",
"telephone_number": "703-978-6061",
"fax_number": "703-978-0291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALCOURT",
"first_name": "MARYANN",
"credential": "CPNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-16",
"last_updated": "2020-01-16",
"certification_date": "2020-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "VA",
"license": "0024164946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.