Individual provider Active NPI

Lauren Muckelvene, FNP-C

  • Family Nurse Practitioner
  • Woodbridge, VA
National Provider Identifier
1407622533
Registry record updated Feb 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024188844 Issued in VA
Practice address
2200 Opitz Blvd Ste 320
Woodbridge, VA 22191-3349
Phone
(703) 770-6077
NPI assigned
Nov 29, 2023
Last updated
Feb 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 0024188844 VA Primary

Addresses

Primary practice location

2200 Opitz Blvd Ste 320
Woodbridge, VA 22191-3349

Mailing address

900 Army Navy Dr Apt 1419
Arlington, VA 22202-4932
Phone (703) 447-7102

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
I20240418000137 VA Practitioner - Nurse Practitioner 1759720139 Reassigns benefits to 1 organization
I20250821003717 DC Practitioner - Nurse Practitioner 1759720139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024188844VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Single Specialty CurrentSince Feb 6, 2024 Accepting new patients
Privia Medical Group, LLC CurrentSince Feb 6, 2024 Accepting new patients
Medical Associates of Central Virginia, Inc. Single Specialty Past Accepting new patients

Locations

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

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

8644 Sudley Rd
#220
Manassas, VA 20110

5510 Alma Ln
Springfield, VA 22151
Phone (703) 642-5990

2200 Opitz Blvd
Ste 320
Woodbridge, VA 22191
Phone (703) 770-6077

Interoperability endpoints

  • Direct secure messaging: lauren.muckelvene.1@8042.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1701216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707609600000",
    "number": "1407622533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ARMY NAVY DR APT 1419",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222024932",
            "telephone_number": "703-447-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 OPITZ BLVD STE 320",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913349",
            "telephone_number": "703-770-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCKELVENE",
        "first_name": "LAUREN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-29",
        "last_updated": "2024-02-11",
        "certification_date": "2024-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024188844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.