Individual provider Active NPI

Leslianne Grendysz, LNP

  • Family Nurse Practitioner
  • Lake Ridge, VA
National Provider Identifier
1346470598
Registry record updated Oct 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024168382 Issued in VA
Practice address
12825 Minnieville Rd
Suite 202
Lake Ridge, VA 22192-3618
Phone
(703) 780-2800
Fax
(703) 780-0461
NPI assigned
Jul 22, 2009
Last updated
Oct 23, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2013

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 0024168382 VA Primary

Addresses

Primary practice location

12825 Minnieville Rd
Suite 202
Lake Ridge, VA 22192-3618

Mailing address

12825 Minnieville Rd
Suite 202
Lake Ridge, VA 22192-3618
Phone (703) 780-2800

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
I20091005000464 VA Practitioner - Nurse Practitioner 5890831861 Reassigns benefits to 2 organizations
I20140730000239 DC Practitioner - Nurse Practitioner 5890831861 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024168382VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince May 16, 2016 Accepting new patients
Inova Health Care Services CurrentSince May 16, 2016 Accepting new patients
Chiropractic Initiatives, Inc Past Accepting new patients

Locations

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

8100 Ashton Ave
Ste 200
Manassas, VA 20109
Phone (571) 581-1771

1850 Town Center Pkwy
Ste 566
Reston, VA 20190

422 Garrisonville Rd
Ste 110
Stafford, VA 22554
Phone (540) 657-6400

415 Church St NE
Ste 101
Vienna, VA 22180
Phone (571) 432-9454

559 Frost Ave
Ste 102
Warrenton, VA 20186
Phone (540) 341-7530

Interoperability endpoints

  • Direct secure messaging: leslianne.grendysz.p1@direct.chv.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382486400000",
    "number": "1346470598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12825 MINNIEVILLE RD",
            "address_2": "SUITE 202",
            "city": "LAKE RIDGE",
            "state": "VA",
            "postal_code": "221923618",
            "telephone_number": "703-780-2800",
            "fax_number": "703-780-0461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12825 MINNIEVILLE RD",
            "address_2": "SUITE 202",
            "city": "LAKE RIDGE",
            "state": "VA",
            "postal_code": "221923618",
            "telephone_number": "703-780-2800",
            "fax_number": "703-780-0461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRENDYSZ",
        "first_name": "LESLIANNE",
        "credential": "LNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-22",
        "last_updated": "2013-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024168382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ridge, VA

Sources for this page

Verify at the official NPI Registry.