Organization Active NPI

Speer Primary Care LLC

  • Family Nurse Practitioner
  • Herndon, VA
National Provider Identifier
1205535945
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
SPEER PRIMARY CARE LLC
Practice address
445 Carlisle Dr Ste a
Herndon, VA 20170-5622
Phone
(703) 794-3741
Fax
(888) 873-0027
NPI assigned
Mar 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Authorized official

Name
Janice Speer, NPNPI 1316295991
Title
NP
Phone
(703) 501-0107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

445 Carlisle Dr Ste a
Herndon, VA 20170-5622

Mailing address

445 Carlisle Dr Ste a
Herndon, VA 20170-5622
Phone (703) 794-3741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230818001309 DC Part B Supplier - Clinic/Group Practice 5193187409 Receives reassigned benefits from 1 practitioner
Practice locations: Herndon, VA

National Provider Directory

National Provider Directory

Locations

445 Carlisle Dr
Ste A
Herndon, VA 20170
Phone (703) 794-3741

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687824000000",
    "number": "1205535945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 CARLISLE DR STE A",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705622",
            "telephone_number": "703-794-3741",
            "fax_number": "800-873-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 CARLISLE DR STE A",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705622",
            "telephone_number": "703-794-3741",
            "fax_number": "888-873-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEER PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-02",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A",
        "authorized_official_last_name": "SPEER",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "703-501-0107",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.

Verify at the official NPI Registry.