Individual provider Active NPI

Johnna Stoup, AUD

  • Audiologist
  • Alexandria, VA
National Provider Identifier
1346975067
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2201001884 Issued in VA
Practice address
2616 Sherwood Hall LN Ste 408
Alexandria, VA 22306-3154
Phone
(703) 780-8929
Fax
(703) 921-1056
NPI assigned
Jul 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2201001884 VA Primary

Addresses

Primary practice location

2616 Sherwood Hall LN Ste 408
Alexandria, VA 22306-3154

Mailing address

6355 Walker LN Ste 411
Alexandria, VA 22310-3250
Phone (703) 922-4262

Other practice location 1

6355 Walker Ln Ste 411
Alexandria, VA 22310-3250
Phone (703) 922-4262

Other identifiers 2

IdentifierTypeStateIssuer
2201001884OtherVAVIRGINIA LICENSE
15593720OtherCAQH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address johnna@alexandriahearing.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230701000430 DC Practitioner - Qualified Audiologist 5991164352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

1635 N George Mason Dr
490 Arlington Prim Care
Arlington, VA 22205-3601
Phone (703) 522-5300

9470 Annapolis Rd
Suite 309
Lanham, MD 20706-3022
Phone (202) 832-1800

950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2201001884VAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Apr 23, 2024 Accepting new patients
Privia Medical Group, LLC CurrentSince Apr 23, 2024 Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

2616 Sherwood Hall Ln
Ste 408
Alexandria, VA 22306
Phone (703) 780-5073

6355 Walker Ln
Ste 411
Alexandria, VA 22310
Phone (703) 313-0373

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8220/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1346975067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 WALKER LN STE 411",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103250",
            "telephone_number": "703-922-4262",
            "fax_number": "703-921-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2616 SHERWOOD HALL LN STE 408",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223063154",
            "telephone_number": "703-780-8929",
            "fax_number": "703-921-1056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6355 Walker Ln Ste 411",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223103250",
            "country_code": "US",
            "telephone_number": "703-922-4262",
            "fax_number": "703-921-1056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOUP",
        "first_name": "JOHNNA",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-18",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA LICENSE",
            "identifier": "2201001884",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15593720",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "johnna@alexandriahearing.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6355 Walker Ln Ste 411",
            "city": "Alexandria",
            "state": "VA",
            "country_code": "US",
            "postal_code": "223103250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.