Penelope Maria Dube, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

0002099105 Issued in VA

Practice address

21035 Sycolin Rd Ste 55
Ashburn, VA 20147-4311

Phone

(703) 496-4616

Fax

(703) 496-4615

NPI assigned

Dec 19, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Sweet Virginia Care WV, LLC

  dba BrightStar Care of WV

  • Nursing Care Agency
  • Chester, WV
  • NPI 1396506473
  NPD

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

{
    "created_epoch": "1734566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1629886957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21035 SYCOLIN RD STE 55",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201474311",
            "telephone_number": "703-496-4616",
            "fax_number": "703-496-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21035 SYCOLIN RD STE 55",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201474311",
            "telephone_number": "703-496-4616",
            "fax_number": "703-496-4615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Lotus Ave",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "WV",
            "postal_code": "260341552",
            "country_code": "US",
            "telephone_number": "866-520-1989",
            "fax_number": "703-496-4615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBE",
        "first_name": "PENELOPE",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "VA",
            "license": "0002099105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Shane Costa/Little Smiles
• Charlotte A Dries, PT
• Robert Jeffrey Droter, PT, DPT, OCS
• DRS Bachour & Church, PLLC
• DRS. Woo & Ullrich - Nova Pdo, PLLC
• Matthew Dudek, D.M.D
• Michael Duggan, RPH
• Emilie Duke, FNP
• Dulles Urgent Care Center LLC
• Dulles Vein and Surgical Clinics LLC

• Licensed Practical Nurse in Ashburn, VA
• Providers in Ashburn, 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 Dec 19, 2024; 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.