Active NPI
Soo Min Summer Dewenter
- Certified Registered Nurse Anesthetist
- Falls Church, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 0024180857
- Practice address
- 3300 Gallows Rd
Falls Church, VA 22042-3307 - Phone
- (703) 776-4001
- NPI assigned
- Jan 28, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0001274958 | VA | |
| Certified Registered Nurse Anesthetist | 367500000X | 0024180857 | VA | Primary |
Addresses
Primary practice location
3300 Gallows Rd
Falls Church, VA 22042-3307
Mailing address
2807 S Woodrow St Apt B
Arlington, VA 22206-3321
Phone (571) 275-0704
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, DC
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2501 Parkers LN
Alexandria, VA 22306-3209
Phone (703) 664-7000
3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001
Hospital & facility affiliations
- Inova Fairfax Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024180857 | VA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Anesthesiology of Virginia, PC | Current | Accepting new patients | |
| American Anesthesiology of Virginia PC | Current | Accepting new patients | |
| Northstar Anesthesia of Virginia, LLC | Current | Accepting new patients |
Locations
2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000
736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124
541 Sunset Ln
Ste 201
Culpeper, VA 22701
Phone (540) 829-0700
3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395
19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950
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.
-
- Anesthesiology Physician
- Leesburg, VA
- NPI 1053675199
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- Falls Church, VA
- NPI 1588795462
-
- General Acute Care Hospital
- Falls Church, VA
- NPI 1831220714
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611792000000",
"number": "1437740982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2807 S WOODROW ST APT B",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "222063321",
"telephone_number": "571-275-0704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 GALLOWS RD",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220423307",
"telephone_number": "703-776-4001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEWENTER",
"first_name": "SOO MIN",
"middle_name": "SUMMER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-28",
"last_updated": "2021-01-28",
"certification_date": "2021-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "VA",
"license": "0001274958",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "VA",
"license": "0024180857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Falls Church, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.