Lynn House of Potomac Valley Inc

Primary specialty

Religious Nonmedical Nursing PersonnelTaxonomy code 374T00000X

Legal business name

LYNN HOUSE OF POTOMAC VALLEY INC

Practice address

4400 W Braddock Rd
Alexandria, VA 22304-1010

Phone

(703) 379-6000

Fax

(703) 671-8897

NPI assigned

Sep 14, 2006

Last updated

Sep 12, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susan Orttung

Title

Executive Director

Phone

(703) 379-6000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235235805. Details of each certification follow.

• CCN 491991 Hospital · Active · Name & address match · Details

Hospital certification: CCN 491991

Legal name

LYNN HOUSE OF POTOMAC VALLEY

Certification status

Active

Provider type (POS)

Hospital – Religious non-medical health care institution

Participating since

Jan 5, 2001

Last certification

Jul 12, 2005

Beds

16

Ownership / control type

Church

Facility address

4400 West Braddock Road
Alexandria, VA 22304

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rose Mudida

  • Nursing Home Administrator
  • Alexandria, VA
  • NPI 1164143871
  NPD
• Mary R. Ladson

  • Religious Nonmedical Nursing Personnel
  • Alexandria, VA
  • NPI 1053753939
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1235235805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 W BRADDOCK ROAD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041010",
            "telephone_number": "703-379-6000",
            "fax_number": "703-671-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W BRADDOCK RD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041010",
            "telephone_number": "703-379-6000",
            "fax_number": "703-671-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNN HOUSE OF POTOMAC VALLEY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "ORTTUNG",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "703-379-6000"
    },
    "taxonomies": [
        {
            "code": "374T00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Nursing Personnel",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asta Annette Lynch, LCSW
• Cheryl V Lynch, CRNA
• Hope Latrice Lynch, PDW
• Margaret Connors Lynch, M.D.
• Sabrina Lynch, LPC
• Leslie Lyon, FNP-BC
• Maureen E. Lyon, PH. D.
• Jennifer Lyons
• Margaret Ellen Lyons, LCSW
• Raymond David Lyons, LICSW

• Religious Nonmedical Nursing Personnel in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Religious Nonmedical Nursing Personnel in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.