Individual provider Active NPI

Susan Leslie Lansbury, CRNP

  • Nurse Practitioner
  • Fredericksburg, VA
National Provider Identifier
1619043908
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
002410447 Issued in VA
Practice address
200 Executive Center Pkwy
Suite #106
Fredericksburg, VA 22401-3177
Phone
(540) 899-3440
Fax
(540) 899-3434
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 002410447 VA Primary

Addresses

Primary practice location

200 Executive Center Pkwy
Suite #106
Fredericksburg, VA 22401-3177

Mailing address

200 Executive Center Pkwy
Suite #106
Fredericksburg, VA 22401-3177
Phone (540) 899-3440

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070625000779 VA Practitioner - Nurse Practitioner 2961501390 Reassigns benefits to 1 organization
I20150225000829 DC Practitioner - Nurse Practitioner 2961501390 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002410447VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Specialists of Virginia, LLC CurrentSince Jan 1, 2015 Accepting new patients
Family Focus, LLC Past Accepting new patients

Locations

3023 Hamaker Ct
Ste 400
Fairfax, VA 22031
Phone (571) 226-8380

14904 Richmond Hwy
Woodbridge, VA 22191
Phone (703) 492-6660

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285718400000",
    "number": "1619043908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 EXECUTIVE CENTER PKWY",
            "address_2": "SUITE #106",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013177",
            "telephone_number": "540-899-3440",
            "fax_number": "540-899-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EXECUTIVE CENTER PKWY",
            "address_2": "SUITE #106",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013177",
            "telephone_number": "540-899-3440",
            "fax_number": "540-899-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANSBURY",
        "first_name": "SUSAN",
        "middle_name": "LESLIE",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2010-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "002410447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.