Individual provider Active NPI

Nitnoy Badgley

  • Family Nurse Practitioner
  • Fairfax, VA
National Provider Identifier
1194844951
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024115883 Issued in VA
Practice address
3650 Joseph Siewick Dr Ste 110
Fairfax, VA 22033-1711
Phone
(703) 391-8804
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024115883 VA Primary
Registered Nurse 163W00000X 0001115883 VA

Addresses

Primary practice location

3650 Joseph Siewick Dr Ste 110
Fairfax, VA 22033-1711

Mailing address

3650 Joseph Siewick Dr Ste 110
Fairfax, VA 22033-1711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051028000422 DC Practitioner - Nurse Practitioner 3577580521 Reassigns benefits to 1 organization
I20160909001359 VA Practitioner - Nurse Practitioner 3577580521 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001115883VAMDRegistered Nurse
0024115883VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Virginia LLC Family CurrentSince Jun 27, 2016 Accepting new patients
Gastroenterology Associates of Northern Virginia, LLC Past Accepting new patients
Old Dominion Anesthesia LLC Past Accepting new patients

Locations

1636 Belle View Blvd
Alexandria, VA 22307
Phone (703) 703-7687

19305 Ruby Dr
Leesburg, VA 20176
Phone (571) 333-5918

1452 Chain Bridge Rd
McLean, VA 22101
Phone (703) 307-8235

Organizations & group practices 4

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1194844951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 JOSEPH SIEWICK DR STE 110",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 JOSEPH SIEWICK DR STE 110",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331711",
            "telephone_number": "703-391-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADGLEY",
        "first_name": "NITNOY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024115883",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001115883",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.