Individual provider Active NPI

Shripriya Mohan O'Neill, CPNP

  • Pediatric Nurse Practitioner
  • Fairfax, VA
National Provider Identifier
1265990212
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
NP1049347 Issued in DC
Practice address
3023 Hamaker CT Ste 300
Fairfax, VA 22031-2240
Phone
(703) 280-3850
NPI assigned
Mar 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024177244 VA
Pediatric Nurse Practitioner 363LP0200X 0024177244 VA
Pediatric Nurse Practitioner 363LP0200X NP1049347 DC Primary

Addresses

Primary practice location

3023 Hamaker CT Ste 300
Fairfax, VA 22031-2240

Mailing address

219 Gentry Ave
Alexandria, VA 22305-1816
Phone (585) 771-0661

Other practice location 1

5028 Wisconsin Ave NW
Washington, DC 20016-4118
Phone (202) 895-3860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201215001720 DC Practitioner - Nurse Practitioner 8426460569 Reassigns benefits to 1 organization
I20220506000205 VA Practitioner - Nurse Practitioner 8426460569 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024177244VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital CurrentSince Sep 20, 2024 Accepting new patients
Children's Hospital CurrentSince Sep 20, 2024 Accepting new patients
Children's Hospital CurrentSince Sep 1, 2024 Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

5028 Wisconsin Ave NW
Washington, DC 20016
Phone (202) 237-2700

7125 13th Pl NW
Washington, DC 20012
Phone (202) 545-2500

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

3023 Hamaker Ct
Ste 300
Fairfax, VA 22031
Phone (703) 848-6627

Organizations & group practices 4

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": "1552003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1265990212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 GENTRY AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223051816",
            "telephone_number": "585-771-0661",
            "fax_number": "202-448-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 HAMAKER CT STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312240",
            "telephone_number": "703-280-3850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5028 Wisconsin Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200164118",
            "country_code": "US",
            "telephone_number": "202-895-3860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "SHRIPRIYA",
        "middle_name": "MOHAN",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-08",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024177244",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024177244",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "DC",
            "license": "NP1049347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.