Individual provider Active NPI

Fatmata Endeley, MSN, BSN, RN.

  • Registered Nurse
  • Stafford, VA
National Provider Identifier
1548949019
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
0001285661 Issued in VA
Practice address
800 Corporate Dr Ste 362
Stafford, VA 22554-4889
Phone
(540) 930-4081
NPI assigned
Jul 12, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 0001285661 VA Primary

Addresses

Primary practice location

800 Corporate Dr Ste 362
Stafford, VA 22554-4889

Mailing address

800 Corporate Dr Ste 362
Stafford, VA 22554-4889
Phone (540) 930-4081

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
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001285661VAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Glory Days Residential Services Current Accepting new patients
Glory Days Healthcare LLC CurrentSince Jul 31, 2023 Accepting new patients

Locations

800 Corporate Dr
Ste 362
Stafford, VA 22554
Phone (540) 930-4081

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.

NPI Registry JSON

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1548949019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CORPORATE DR STE 362",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225544889",
            "telephone_number": "540-930-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 CORPORATE DR STE 362",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225544889",
            "telephone_number": "540-930-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDELEY",
        "first_name": "FATMATA",
        "credential": "MSN, BSN, RN.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001285661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.