Elisabeth Anne Boettke, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024196642 Issued in VA

Practice address

381 Elden St Ste 1000
Herndon, VA 20170-4842

Phone

(703) 424-4671

NPI assigned

Feb 18, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Specialty

Nurse Practitioner

Education

University of South Alabama College of Medicine, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairfax Family Practice Centers PCGroup PAC ID 4082513031, 106 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Fairfax Family Practice Centers PC

  • Family Medicine Physician
  • Herndon, VA
  • NPI 1205944964

  DC

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1771372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1285587378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14622 CROATAN DR",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201202981",
            "telephone_number": "703-424-4671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 ELDEN ST STE 1000",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704842",
            "telephone_number": "703-424-4671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOETTKE",
        "first_name": "ELISABETH",
        "middle_name": "ANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-18",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024196642",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001268093",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Blanding, PA-C
• Shannon Bloch, DC
• Victoria Block, PT
• Bloom Home Care LLC
• Thea N Boatswain, MS, RD
• Ioana Boie, PHD
• Sage Annaleise Bolte, PHD, LCSW, OSW-C
• Aruna Borkar, MSPT
• BPT Wellness
• Jocelyn Brackett, FNP-B.C.

• Family Nurse Practitioner in Herndon, VA
• Providers in Herndon, 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 Mar 23, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.