Individual provider Active NPI

Nancy Dimascio-Johnson, FNP-C

  • Nurse Practitioner
  • Fort Belvoir, VA
National Provider Identifier
1285600700
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024165365 Issued in VA
Practice address
9300 Dewitt Loop
Fort Belvoir, VA 22060-5285
Phone
(571) 231-1402
Fax
(571) 231-6641
NPI assigned
Feb 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024165365 VA
Family Nurse Practitioner 363LF0000X F331498-1 NY
Nurse Practitioner 363L00000X 0024165365 VA Primary

Addresses

Primary practice location

9300 Dewitt Loop
Fort Belvoir, VA 22060-5285

Mailing address

100 Wilderness LN
Fredericksburg, VA 22401-2250
Phone (703) 784-1885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20191114000749 VA Order and Referring Only - Nurse Practitioner 8628400595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F331498-1NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1285600700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILDERNESS LN",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224012250",
            "telephone_number": "703-784-1885",
            "fax_number": "703-784-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-231-1402",
            "fax_number": "571-231-6641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMASCIO-JOHNSON",
        "first_name": "NANCY",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024165365",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F331498-1",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024165365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Belvoir, VA

Sources for this page

Verify at the official NPI Registry.