Individual provider Active NPI

Kaelin Jennison, RN, FNP-BC

  • Family Nurse Practitioner
  • Vienna, VA
National Provider Identifier
1487306478
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024187529 Issued in VA
Practice address
115 Park St SE Ste 300
Vienna, VA 22180-4653
Phone
(703) 255-9100
Fax
(703) 255-3457
NPI assigned
Jan 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001280015 VA
Family Nurse Practitioner 363LF0000X 0024187529 VA Primary

Addresses

Primary practice location

115 Park St SE Ste 300
Vienna, VA 22180-4653

Mailing address

115 Park St SE Ste 300
Vienna, VA 22180-4653
Phone (703) 255-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20231228003875 DC Practitioner - Nurse Practitioner 7214387521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Physician Partners LLCGroup PAC ID 2466581772, 258 clinicians

Practice addresses (Care Compare)

115 Park St SE
300 Vienna Family Medicine
Vienna, VA 22180-4653
Phone (703) 255-9100

Hospital & facility affiliations

  • Inova Alexandria Hospital Hospital, Alexandria, VA, CCN 490040
  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063

Merit-based Incentive Payment System (MIPS)

Final score
93.98 of 100Reported as apm
Quality
87.97
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001280015VAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Physician Partners, LLC CurrentSince Oct 30, 2023 Accepting new patients
Inova Physician Partners, Inc. - Specialists Past Accepting new patients

Locations

7619 Little River Tpke
Ste 1000
Annandale, VA 22003
Phone (703) 256-5680

3914 Centreville Rd
Ste 250
Chantilly, VA 20151
Phone (703) 435-1223

8095 Innovation Park Dr
Bldg C
Fairfax, VA 22031
Phone (571) 472-6253

115 Park St SE
Ste 300
Vienna, VA 22180
Phone (703) 255-9100

Interoperability endpoints

  • Direct secure messaging: kjennison314545@soc.inova.org

Organizations & group practices 2

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 3

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": "1642723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1487306478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 PARK ST SE STE 300",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804653",
            "telephone_number": "703-255-9100",
            "fax_number": "703-255-3457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PARK ST SE STE 300",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804653",
            "telephone_number": "703-255-9100",
            "fax_number": "703-255-3457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNISON",
        "first_name": "KAELIN",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-21",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001280015",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024187529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

Verify at the official NPI Registry.