Brightstone, LLC
Organization Active NPI Nurse Practitioner · Bristow, VA
NPI 1538726203 · NPPES record last updated Aug 24, 2023
Key facts
- NPI
- 1538726203
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- Legal business name
- BRIGHTSTONE, LLC
- Practice address
- 10040 Pentland Hills Way
Bristow, VA 20136 - Phone
- (202) 888-4959
- Fax
- (703) 995-0930
- NPI assigned
- May 28, 2019
- Organization subpart
- No
Authorized official
- Name
- Dr. Johanna Lynn Gaskins, DNP, APRN, AGNP-C
- Title
- Owner
- Phone
- (202) 888-4959
Practitioners 7
-
Johanna Lynn Gaskins, DNP, APRN, AGNP-C
-
Bessie J Raines, NP
-
Allison Edna Roca, DNP
-
Elizabeth DO Roth, FNP-C
-
Mary Susan Lefande, DNP, MSN, RN, FNP-BC
-
Amanda Abrams, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VA, DC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190729002543 | VA | Part B Supplier - Clinic/Group Practice | 5395071351 |
Receives reassigned benefits from 6 practitioners Practice locations: Bristow, VA |
| O20231130000049 | DC | Part B Supplier - Clinic/Group Practice | 5395071351 |
Receives reassigned benefits from 6 practitioners Practice locations: Bristow, VA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | |||
| Nurse Practitioner |
363L00000X | Yes |
Addresses
Primary practice location
10040 Pentland Hills Way
Bristow, VA 20136
Mailing address
10040 Pentland Hills Way
Bristow, VA 20136-2665
Phone (202) 497-8348
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10145009 | Medicaid | VA |
Other names
- Seek Wellbeing Housecalls Program
Other providers in Bristow, VA
- Kristie Bombara
- Nina Bowley
- Bright Horizons Services Home Health Company LLC
- Samuel Agyei Bright
- Brighter Way Transport LLC
- Bristow Endodontic Associates PLLC
- Bristow Fountain Dentistry, PC
- Bristow Pediatrics
- Bristow Physical Therapy & Chiropractic, LLC
- Bristow Urgent Care Center LLC
All providers in Bristow, VA · Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.