Active NPI
Speer Primary Care LLC
- Family Nurse Practitioner
- Herndon, VA
National Provider Identifier
1205535945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Janice Speer, NP
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230818001309 | DC | Part B Supplier - Clinic/Group Practice | 5193187409 |
Receives reassigned benefits from 1 practitioner Practice locations: Herndon, VA |
National Provider Directory
National Provider DirectoryLocations
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.