Elise Madjo Gaston, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

0002085420 Issued in VA

Practice address

12903 Pinecrest Rd
Herndon, VA 20171-2601

Phone

(703) 597-2988

NPI assigned

Mar 16, 2012

Last updated

Mar 16, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1331856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331856000000",
    "number": "1558636019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12903 PINECREST RD",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201712601",
            "telephone_number": "703-597-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12903 PINECREST RD",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201712601",
            "telephone_number": "703-597-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASTON",
        "first_name": "ELISE",
        "middle_name": "MADJO",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-16",
        "last_updated": "2012-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "VA",
            "license": "1401140286",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "VA",
            "license": "0002085420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rechel Qingyan Gao
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• Erin Garvey, RDN
• Lisa Gay, PT
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• Lucy Geer, MS, LBA, BCBA
• Michael J Gennari, PHD
• Anu Jeswin George

• Licensed Practical Nurse in Herndon, VA
• Providers in Herndon, VA by specialty
• Licensed Practical Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2012; 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.