Individual provider Active NPI

Narayana Gabriel Pennington

  • Family Nurse Practitioner
  • Fairfax, VA
National Provider Identifier
1275200263
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024182301 Issued in VA
Practice address
3053 Nutley St
Fairfax, VA 22031-1931
Phone
(703) 560-4862
NPI assigned
Aug 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024182301 VA Primary

Addresses

Primary practice location

3053 Nutley St
Fairfax, VA 22031-1931

Mailing address

3053 Nutley St
Fairfax, VA 22031-1931
Phone (703) 560-4862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 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
I20211206001790 VA Practitioner - Nurse Practitioner 1951791912
I20220228000043 DC Practitioner - Nurse Practitioner 1951791912

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024182301VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Happy Health and Wellness LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DHGFDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/DFGDDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/AGCFDD

Organizations & group practices 1

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": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1275200263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3053 NUTLEY ST",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220311931",
            "telephone_number": "703-560-4862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3053 NUTLEY ST",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220311931",
            "telephone_number": "703-560-4862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "NARAYANA",
        "middle_name": "GABRIEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024182301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.