Individual provider Active NPI

Rose Mary Laguardia, FNP

  • Family Nurse Practitioner
  • Manassas, VA
National Provider Identifier
1598067324
Registry record updated Aug 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024169103 Issued in VA
Practice address
9001 Digges Rd
Suite 107
Manassas, VA 20110
Phone
(703) 330-1112
Fax
(703) 330-3113
NPI assigned
Nov 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024169103 VA Primary

Addresses

Primary practice location

9001 Digges Rd
Suite 107
Manassas, VA 20110

Mailing address

9001 Digges Rd
Suite 107
Manassas, VA 20110
Phone (703) 330-1112

Other names 1

  • Rose Mary Kelly Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024169103VAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440115200000",
    "number": "1598067324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9001 DIGGES RD",
            "address_2": "SUITE 107",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "20110",
            "telephone_number": "703-330-1112",
            "fax_number": "703-330-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 DIGGES RD",
            "address_2": "SUITE 107",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "20110",
            "telephone_number": "703-330-1112",
            "fax_number": "703-330-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGUARDIA",
        "first_name": "ROSE",
        "middle_name": "MARY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-30",
        "last_updated": "2015-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024169103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSE",
            "last_name": "KELLY",
            "middle_name": "MARY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.