Individual provider Active NPI

Sushma Shrestha

  • Pediatric Nurse Practitioner
  • Manassas, VA
National Provider Identifier
1548975949
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024186087 Issued in VA
Practice address
9705 Liberia Ave
Manassas, VA 20110-1743
Phone
(703) 680-7950
NPI assigned
Jan 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0024186087 VA Primary

Addresses

Primary practice location

9705 Liberia Ave
Manassas, VA 20110-1743

Mailing address

12211 Apple Orchard CT
Fairfax, VA 22033-2817
Phone (434) 227-0331

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
I20230518002486 VA Practitioner - Nurse Practitioner 7719343698 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Prince William Area Community Health Center Inc CurrentSince Apr 10, 2023 Accepting new patients
Greater Prince William Area Community Health Center Inc CurrentSince Apr 10, 2023 Accepting new patients
Greater Prince William Area Community Health Center Inc Past Accepting new patients
Greater Prince William Area Community Health Center Inc Past Accepting new patients

Locations

17739 Main St
Ste 130
Dumfries, VA 22026
Phone (703) 680-7950

9705 Liberia Ave
Ste 201
Manassas, VA 20110
Phone (703) 519-1725

9705 Liberia Ave
Manassas, VA 20110
Phone (703) 680-7950

3350 Commission Ct
Woodbridge, VA 22192
Phone (703) 680-7950

Interoperability endpoints

  • Direct secure messaging: sushma.shrestha@gpwchc.eclinicaldirectplus.com

Organizations & group practices 4

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": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1548975949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12211 APPLE ORCHARD CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332817",
            "telephone_number": "434-227-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9705 LIBERIA AVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201101743",
            "telephone_number": "703-680-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRESTHA",
        "first_name": "SUSHMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-19",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024186087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.