Individual provider Active NPI

Koudahin Latevi Lawson, CRNA

  • Certified Registered Nurse Anesthetist
  • Winchester, VA
National Provider Identifier
1356694814
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024170381 Issued in VA
Practice address
1840 Amherst St
Winchester, VA 22601-2808
Phone
(540) 536-8875
NPI assigned
Oct 22, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 0001240679 VA
Certified Registered Nurse Anesthetist 367500000X 0024170381 VA Primary

Addresses

Primary practice location

1840 Amherst St
Winchester, VA 22601-2808

Mailing address

121 Caledon CT
2
Stephens City, VA 22655-3542
Phone (704) 241-9441

Other practice location 1

101 Hospital Center Blvd
Stafford, VA 22554-6200
Phone (540) 741-7614

Other practice location 2

1201 Sam Perry Blvd Ste 101
Fredericksburg, VA 22401-4490
Phone (540) 741-7614

Other practice location 3

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-7614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130103000412 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466605290 Reassigns benefits to 4 organizations
I20180413001469 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466605290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Washington Healthcare Specialty Services, LLCGroup PAC ID 5991605826, 136 clinicians

Practice addresses (Care Compare)

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-7614

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 352-9395

8700 Sudley Rd
Manassas, VA 20110-4418
Phone (703) 369-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001240679VAMDCritical Care Medicine Registered Nurse
0024170381VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Anesthesiologists Inc CurrentSince Jun 1, 2022 Accepting new patients
Mary Washington Healthcare Specialty Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2025 Accepting new patients
Winchester Medical Center CurrentSince Nov 19, 2012 Accepting new patients
Winchester Medical Center Current Accepting new patients
American Anesthesiology of Virginia, PC CurrentSince Mar 16, 2018 Accepting new patients
Winchester Medical Center, Inc. CurrentSince Nov 19, 2012 Accepting new patients
Shenandoah Valley Pathology Laboratories Inc Current Accepting new patients
American Anesthesiology of Virginia PC CurrentSince Mar 16, 2018 Accepting new patients

Locations

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

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

1201 Sam Perry Blvd
Ste 101
Fredericksburg, VA 22401
Phone (540) 741-4614

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

101 Hospital Center Blvd
Stafford, VA 22554
Phone (540) 741-3340

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

874 Fox Dr
Winchester, VA 22603
Phone (540) 662-0990

Organizations & group practices 8

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.

Hospital & facility affiliations 4

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": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1356694814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CALEDON CT",
            "address_2": "2",
            "city": "STEPHENS CITY",
            "state": "VA",
            "postal_code": "226553542",
            "telephone_number": "704-241-9441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 AMHERST ST",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012808",
            "telephone_number": "540-536-8875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Hospital Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Stafford",
            "state": "VA",
            "postal_code": "225546200",
            "country_code": "US",
            "telephone_number": "540-741-7614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 Sam Perry Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224014490",
            "country_code": "US",
            "telephone_number": "540-741-7614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Sam Perry Blvd",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224014453",
            "country_code": "US",
            "telephone_number": "540-741-7614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWSON",
        "first_name": "KOUDAHIN",
        "middle_name": "LATEVI",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-22",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "VA",
            "license": "0001240679",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024170381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; 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.