Individual provider Active NPI

Monica Anna Charmok

  • Registered Nurse
  • Vienna, VA
National Provider Identifier
1497010912
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
0001090541 Issued in VA
Practice address
2831 Kelly SQ
Vienna, VA 22181-6143
Phone
(703) 255-0085
Fax
(703) 255-0085
NPI assigned
Jul 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

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 0001090541 VA Primary
Registered Nurse 163W00000X RN1015499 DC

Addresses

Primary practice location

2831 Kelly SQ
Vienna, VA 22181-6143

Mailing address

2831 Kelly SQ
Vienna, VA 22181-6143
Phone (703) 255-0085

Other names 1

  • Monica Anna Willi Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN1015499DCMDRegistered Nurse
0001090541VAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1497010912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 KELLY SQ",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221816143",
            "telephone_number": "703-255-0085",
            "fax_number": "703-255-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 KELLY SQ",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221816143",
            "telephone_number": "703-255-0085",
            "fax_number": "703-255-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARMOK",
        "first_name": "MONICA",
        "middle_name": "ANNA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001090541",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1015499",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONICA",
            "last_name": "WILLI",
            "middle_name": "ANNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.