Ellen Iduma

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024171998 Issued in VA

Practice address

10301 New Guinea Rd
Fairfax, VA 22032-3268

Phone

(703) 764-5112

NPI assigned

Sep 27, 2014

Last updated

Jan 3, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ellen John Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ritecare Concept LLC

  • Community/Behavioral Health Agency
  • Fairfax, VA
  • NPI 1083260798
  NPD Authorized official
• Ritecare Home Health Services

  • Personal Care Attendant
  • Springfield, VA
  • NPI 1154078731
  NPD Authorized official
• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061
  NPD
• Strategic Wellness Advocates LLC

  • Rehabilitation Clinic/Center
  • Baltimore, MD
  • NPI 1740968346
  NPD (past)

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

{
    "created_epoch": "1411776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1417350018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9420 PARK HUNT CT",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221531351",
            "telephone_number": "703-909-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 NEW GUINEA RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220323268",
            "telephone_number": "703-764-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDUMA",
        "first_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-27",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024171998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "JOHN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Naida Ibrisimovic
• Kevin Ichaso
• Iconic Dagnostic Imaging Inc
• Kyran Ide
• Oluwatoyin Temitope Idowu, M.D.
• Ifrc, LLC
• Samone Ighofose, NP-C
• Marianne Ihde
• Magnus Kehinde Ikhinmwin, MD
• Carly Ikuma

• Family Nurse Practitioner in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.