Abigail Atienza Phillips, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024151095 Issued in VA

Practice address

Potomac Center Office
2296 Opitz Blvd., Ste. 300
Woodbridge, VA 22191-3354

Phone

(703) 523-0998

NPI assigned

Dec 1, 2006

Last updated

Apr 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Georgetown University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, shared by 17 NPIs, 1,921 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aphillips621705@direct.sentara.net

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Tysons Corner Medical Center Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • McLean, VA
  • NPI 1073678637

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Caton Hill Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Woodbridge, VA
  • NPI 1114677572
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Loudoun Medical Center

  • Health Maintenance Organization
  • Lansdowne, VA
  • NPI 1861552721
  Medicare reassignment NPD
• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Annapolis Medical Center

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Gaithersburg Medical Center

  • Health Maintenance Organization
  • Gaithersburg, MD
  • NPI 1831471713
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Shady Grove Peritoneal Dialysis Facility

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1548338973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POTOMAC CENTER OFFICE",
            "address_2": "2296 OPITZ BLVD., STE. 300",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22191",
            "telephone_number": "703-523-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "POTOMAC CENTER OFFICE",
            "address_2": "2296 OPITZ BLVD., STE. 300",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913354",
            "telephone_number": "703-523-0998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13900 Church Hill Drive",
            "address_2": "Prince William Area Free Clinic a St. Margaret's Church",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "22191",
            "country_code": "US",
            "telephone_number": "703-499-9034",
            "fax_number": "703-499-9035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "ABIGAIL",
        "middle_name": "ATIENZA",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2023-04-05",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024151095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13900 Church Hill Drive",
            "address_2": "Prince William Area Free Clinic a St. Margaret's Church",
            "city": "Woodbridge",
            "state": "VA",
            "country_code": "US",
            "postal_code": "22191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shawn Ngoc Pham, MSW, LCSW
• Teresa Diemtu Pham, O.D.
• Linh Phan, DDS
• Thoaivan Phan, D.D.S
• Pharmacy One LLC (Pharmacy One)
• Brenda Phoeuk, OT
• Phuong Ngoc Nguyen DMD, PLLC. (Woodbridge Oral & Maxillofacial Surgery Center)
• Physical Medicine Associates LTD (National Spine & Pain Centers)
• Physicians for Ultrasound
• Nikeylah Summone Pickens, LMT

• Family Nurse Practitioner in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.