Individual provider Active NPI

Hannah Lark, CPNP

  • Pediatric Nurse Practitioner
  • Gainesville, VA
National Provider Identifier
1225920838
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024194081 Issued in VA
Practice address
14535 John Marshall Hwy Ste 201
Gainesville, VA 20155-4024
Phone
(703) 753-6184
NPI assigned
Jul 17, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0200X 0024194081 VA Primary

Addresses

Primary practice location

14535 John Marshall Hwy Ste 201
Gainesville, VA 20155-4024

Mailing address

4228 Pennsboro CT
Chantilly, VA 20151-2726
Phone (703) 927-6389

Other practice location 1

10623 Crestwood Dr
Manassas, VA 20109-3433
Phone (703) 361-7131

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
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024194081VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trusted Doctors LLC Single Specialty PastSince Jul 22, 2025 Accepting new patients
Crestwood Pediatric Associates PC Single Specialty Past Accepting new patients

Organizations & group practices 2

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": "1752710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1225920838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 PENNSBORO CT",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201512726",
            "telephone_number": "703-927-6389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14535 JOHN MARSHALL HWY STE 201",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201554024",
            "telephone_number": "703-753-6184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10623 Crestwood Dr",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201093433",
            "country_code": "US",
            "telephone_number": "703-361-7131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARK",
        "first_name": "HANNAH",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-17",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024194081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.