Individual provider Active NPI

Cecile Kormanik Carson, FNP-C

  • Family Nurse Practitioner
  • Leesburg, VA
National Provider Identifier
1386166015
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024175104 Issued in VA
Practice address
44084 Riverside Parkway, Suite 300
Leesburg, VA 20176-5155
Phone
(703) 724-7530
NPI assigned
Jul 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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 0024175104 VA Primary

Addresses

Primary practice location

44084 Riverside Parkway, Suite 300
Leesburg, VA 20176-5155

Mailing address

224-D Cornwall Street, NW, Suite 403
Leesburg, VA 20176-2704
Phone (703) 737-6010

Other practice location 1

19450 Deerfield Ave Ste 325
Leesburg, VA 20176-8503
Phone (571) 252-8119

Other identifiers 2

IdentifierTypeStateIssuer
1386166015MedicaidVA
30016411500001MedicaidVA

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
I20171025000344 VA Practitioner - Nurse Practitioner 1355617044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Johns Hopkins University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Loudoun Medical Group, PCGroup PAC ID 0042119661, 272 clinicians

Practice addresses (Care Compare)

20955 Professional PLZ
Suite 200
Ashburn, VA 20147-3405
Phone (703) 729-7652

44084 Riverside Pkwy
Suite 300
Leesburg, VA 20176-5102
Phone (703) 724-7530

Hospital & facility affiliations

  • Inova Loudoun Hospital Hospital, Leesburg, VA, CCN 490043

Merit-based Incentive Payment System (MIPS)

Final score
92.65 of 100Reported as apm
Quality
85.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024175104VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Medical Group, PC CurrentSince Mar 11, 2018 Accepting new patients
Loudoun Medical Group, PC CurrentSince Mar 11, 2018 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

20955 Professional Plz
Ste 200
Ashburn, VA 20147
Phone (703) 729-7652

19450 Deerfield Ave
Ste 325
Leesburg, VA 20176
Phone (571) 252-8119

224D Cornwall St NW
Ste 403
Leesburg, VA 20176
Phone (703) 737-6001

44084 Riverside Pkwy
Ste 300
Leesburg, VA 20176
Phone (703) 724-7530

205 Hirst Rd
Ste 303
Purcellville, VA 20132
Phone (540) 338-9896

Interoperability endpoints

  • Direct secure messaging: cecile.carson@lmg1.eclinicaldirectplus.com

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 and National Provider Directory roles.

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": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1386166015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224-D CORNWALL STREET, NW, SUITE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44084 RIVERSIDE PARKWAY, SUITE 300",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201765155",
            "telephone_number": "703-724-7530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19450 Deerfield Ave Ste 325",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201768503",
            "country_code": "US",
            "telephone_number": "571-252-8119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARSON",
        "first_name": "CECILE",
        "middle_name": "KORMANIK",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024175104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386166015",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30016411500001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.