Individual provider Active NPI

Maxwell Charles Langhorst, RB, BSN, CCRN, SRNA

  • Certified Registered Nurse Anesthetist
  • Richmond, VA
National Provider Identifier
1508562653
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024192383 Issued in VA
Practice address
1201 E Marshall St
Richmond, VA 23298-5026
Phone
(804) 828-9000
NPI assigned
Jan 31, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Certified Registered Nurse Anesthetist 367500000X 0024192383 VA Primary

Addresses

Primary practice location

1201 E Marshall St
Richmond, VA 23298-5026

Mailing address

101 S Arthur Ashe Blvd Apt 4
Richmond, VA 23220-5772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250306001943 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587185582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Anesthesiology of Virginia PCGroup PAC ID 6800790023, 514 clinicians

Practice addresses (Care Compare)

19455 Deerfield Ave
Suite 204
Leesburg, VA 20176-8102
Phone (703) 724-9950

8262 Atlee Rd
Mechanicsville, VA 23116-1816
Phone (804) 764-6000

Hospital & facility affiliations

  • Bon Secours Memorial Regional Medical Center Hospital, Mechanicsville, VA, CCN 490069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
0024192383VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Virginia, PC CurrentSince Jan 17, 2025 Accepting new patients
American Anesthesiology of Virginia PC CurrentSince Jan 17, 2025 Accepting new patients

Locations

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

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 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": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1508562653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S ARTHUR ASHE BLVD APT 4",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232205772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E MARSHALL ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985026",
            "telephone_number": "804-828-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGHORST",
        "first_name": "MAXWELL",
        "middle_name": "CHARLES",
        "credential": "RB, BSN, CCRN, SRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-31",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024192383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.

Verify at the official NPI Registry.