Active NPI
William Glenn Ivey III, CSA
- Surgical Assistant
- Alexandria, VA
National Provider Identifier
1649150590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 5782
- Practice address
- 4320 Seminary Rd
Alexandria, VA 22304-1535 - Phone
- (703) 504-3000
- NPI assigned
- Sep 3, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 5782 | VA | Primary |
Addresses
Primary practice location
4320 Seminary Rd
Alexandria, VA 22304-1535
Mailing address
4320 Seminary Rd
Alexandria, VA 22304-1535
Phone (703) 504-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5782 | VA | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761264000000",
"number": "1649150590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4320 SEMINARY RD",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223041535",
"telephone_number": "703-504-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4320 SEMINARY RD",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223041535",
"telephone_number": "703-504-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVEY",
"first_name": "WILLIAM",
"middle_name": "GLENN",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "CSA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-09-03",
"last_updated": "2025-10-24",
"certification_date": "2025-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "VA",
"license": "5782",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.