Jennifer Djorup Spyridakis

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024182135 Issued in VA

Practice address

6849 Old Dominion Dr Ste 450
MC Lean, VA 22101-3718

Phone

(703) 356-5111

NPI assigned

Jul 16, 2021

Last updated

Jul 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• McLean Dermatology and Skincare Center

  • Medical Specialty Clinic/Center
  • McLean, VA
  • NPI 1255645776

  DC

  Medicare reassignment NPD
• Potomac Dermatology and Skincare Center

  • Dermatology Physician
  • Potomac, MD
  • NPI 1215685896
  NPD
• McLean Neuropsychiatric Treatment Center LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • McLean, VA
  • NPI 1356935597
  NPD (past)

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1275105314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5213 SIDEBURN RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220322641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6849 OLD DOMINION DR STE 450",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013718",
            "telephone_number": "703-356-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPYRIDAKIS",
        "first_name": "JENNIFER",
        "middle_name": "DJORUP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024182135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittney Lynn Spiker, BCBA
• Melissa Beth Sporn, PH.D.
• Sport & Spine of Rehab McLean PLLC
• Sport Psychs LLC
• James B Sprague, MD
• Pratibha Srinivasan, M.S. CCC-A, CERT AVT
• Sally Sroge, DPT, PT
• Crystal St. Clair, MD
• Olivia Stanford
• Whitney Stang-Miller

• Family Nurse Practitioner in McLean, VA
• Providers in McLean, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.