Individual provider Active NPI

Ashley M Thalacker, FNP-BC

  • Family Nurse Practitioner
  • Leesburg, VA
National Provider Identifier
1346641529
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024171955 Issued in VA
Practice address
44045 Riverside Pkwy
Leesburg, VA 20176-5101
Phone
(703) 858-8074
Fax
(703) 858-6797
NPI assigned
Sep 8, 2014
Last updated
Jun 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024171955 VA
Family Nurse Practitioner 363LF0000X 0024171955 VA Primary

Addresses

Primary practice location

44045 Riverside Pkwy
Leesburg, VA 20176-5101

Mailing address

19993 Presidents Cup Ter
Ashburn, VA 20147-4117

Other names 1

  • Ashley M Renkes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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
I20191001002368 DC Practitioner - Nurse Practitioner 9032449293 Reassigns benefits to 1 organization
I20200727003510 VA Practitioner - Nurse Practitioner 9032449293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

44045 Rivderside Pkwy
Leesburg, VA 20176-5101

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jun 21, 2020 Accepting new patients
Inova Health Care Services CurrentSince Sep 1, 2019 Accepting new patients
Inova Health Care Services CurrentSince Sep 1, 2019 Accepting new patients

Locations

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

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

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

Interoperability endpoints

  • Direct secure messaging: arenkes58483@soc.inova.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1346641529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19993 PRESIDENTS CUP TER",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201474117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44045 RIVERSIDE PKWY",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201765101",
            "telephone_number": "703-858-8074",
            "fax_number": "703-858-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THALACKER",
        "first_name": "ASHLEY",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024171955",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024171955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "RENKES",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.