Active NPI
Eleanor Anne Wilson, DPM
- Podiatrist
- Springfield, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 0103000949
- Practice address
- 6501 Loisdale Court
Springfield, VA 22150-1885 - Phone
- (703) 922-1034
- Fax
- (703) 922-1628
- NPI assigned
- Nov 28, 2006
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 01174 | MD | |
| Podiatrist | 213E00000X | 0103000949 | VA | Primary |
Addresses
Primary practice location
6501 Loisdale Court
Springfield, VA 22150-1885
Mailing address
2101 E Jefferson St Ppqa Medicare Compliance Unit 6 W
Kaiser Permanente Mid Atl Perm Med GRP PC Attn T.Brooks
Rockville, MD 20852-4908
Phone (301) 816-6660
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | |
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA, MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- William M. Scholl College of Podiatric Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700
12255 Fair Lakes Pkwy
Fairfax, VA 22033-3952
Phone (703) 237-4800
125 Hospital Ctr Blvd
Stafford, VA 22554-6202
Phone (540) 602-6500
13285 Minnieville Rd
Woodbridge, VA 22192-4018
Phone (703) 986-2400
14139 Potomac Mills Rd
Woodbridge, VA 22192-4644
Phone (703) 257-3000
6551 Loisdale CT
Springfield, VA 22150-1828
Phone (703) 922-1000
8008 Westpark Dr
MC Lean, VA 22102-3109
Phone (703) 287-6400
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01174 | MD | MD | Podiatrist |
| 0103000949 | VA | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients |
Locations
1701 Twin Springs Rd
Halethorpe, MD 21227
Phone (410) 737-5000
10810 Connecticut Ave
Kensington, MD 20895
Phone (301) 929-7100
1221 Mercantile Ln
Fl 3
Largo, MD 20774
Phone (301) 618-5500
655 Watkins Mill Rd
Montgomery Village, MD 20879
Phone (301) 929-7100
2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852
2101 E Jefferson St
#4E
Rockville, MD 20852
2101 E Jefferson St
Unit 6
Rockville, MD 20852
2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853
2101 E Jefferson St
#6
Rockville, MD 20852
1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500
8008 Westpark Dr
Tysons Corner, VA 22102
Phone (703) 287-6400
14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000
Organizations & group practices 8
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.
-
dba Kaiser Permanente Loudoun Medical Center
- Health Maintenance Organization
- Lansdowne, VA
- NPI 1861552721
-
dba Tysons Corner Medical Center Ambulatory Surgery Center
- Ambulatory Surgical Clinic/Center
- McLean, VA
- NPI 1073678637
DC
-
dba Kaiser Permanente Largo Ambulatory Surgery Center
- Ambulatory Surgical Clinic/Center
- Largo, MD
- NPI 1366781700
DC
-
dba Kaiser Permanente Gaithersburg Medical Center Ambulatory Surgery Ctr
- Ambulatory Surgical Clinic/Center
- Gaithersburg, MD
- NPI 1497023188
DC
-
dba Kensington Ambulatory Surgery Center
- Ambulatory Surgical Clinic/Center
- Kensington, MD
- NPI 1578638425
DC
-
dba So. Baltimore County ASC
- Ambulatory Surgical Clinic/Center
- Halethorpe, MD
- NPI 1942546486
-
dba Kaiser Permanente Annapolis Medical Center
- Health Maintenance Organization
- Annapolis, MD
- NPI 1952461816
DC
-
dba Ashburn Medical Center
- Health Maintenance Organization
- Ashburn, VA
- NPI 1699893537
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644364800000",
"number": "1215003546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNIT 6 W",
"address_2": "KAISER PERMANENTE MID ATL PERM MED GRP PC ATTN T.BROOKS",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208524908",
"telephone_number": "301-816-6660",
"fax_number": "301-816-6308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6501 LOISDALE COURT",
"city": "SPRINGFIELD",
"state": "VA",
"postal_code": "221501885",
"telephone_number": "703-922-1034",
"fax_number": "703-922-1628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ELEANOR",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-28",
"last_updated": "2022-02-09",
"certification_date": "2022-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MD",
"license": "01174",
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "VA",
"license": "0103000949",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "6501 Loisdale Court",
"city": "Springfield",
"state": "VA",
"country_code": "US",
"postal_code": "221501885",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "c-cda",
"address_1": "6501 Loisdale Court",
"city": "Springfield",
"state": "VA",
"country_code": "US",
"postal_code": "221501885",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Springfield, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.