Individual provider Active NPI

Jan S Williams, ACNP, APRN, BC

  • Nurse Practitioner
  • Manassas, VA
National Provider Identifier
1548320492
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024166796 Issued in NC
Practice address
8640 Sudley Rd Ste 302
Manassas, VA 20110-4404
Phone
(703) 369-5959
Fax
(703) 369-7473
NPI assigned
Dec 11, 2006
Last updated
Feb 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024166796 NC Primary

Addresses

Primary practice location

8640 Sudley Rd Ste 302
Manassas, VA 20110-4404

Mailing address

PO Box 748613
Atlanta, GA 30384-8613

Other practice location 1

8700 Sudley Rd
Prince William Hospital
Manassas, VA 20110-4418
Phone (703) 926-0909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20180423000944 VA Practitioner - Nurse Practitioner 4789975806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Georgetown University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8640 Sudley Rd
Suite 302
Manassas, VA 20110-4404
Phone (703) 369-5959

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024166796NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Uva Community Health Medical Group, LLC CurrentSince Mar 1, 2018 Accepting new patients
Uva Community Health Medical Group, LLC CurrentSince Mar 1, 2018 Accepting new patients
Uva Community Health Medical Group, LLC Past Accepting new patients

Locations

4105 Lewis and Clark Dr
Charlottesvle, VA 22911

8640 Sudley Rd
Ste 302
Manassas, VA 20110
Phone (703) 369-5959

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1548320492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748613",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848613",
            "fax_number": "703-369-7473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8640 SUDLEY RD STE 302",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104404",
            "telephone_number": "703-369-5959",
            "fax_number": "703-369-7473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8700 Sudley Rd",
            "address_2": "Prince William Hospital",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201104418",
            "country_code": "US",
            "telephone_number": "703-926-0909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JAN",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "ACNP, APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "0024166796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.