Individual provider Active NPI

Susan Richards White, MSN

  • Acute Care Nurse Practitioner
  • Alexandria, VA
National Provider Identifier
1649592148
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
24168767 Issued in VA
Practice address
4320 Seminary Rd
Alexandria, VA 22304-1535
Phone
(703) 504-3890
NPI assigned
Feb 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 1203038 VA
Acute Care Nurse Practitioner 363LA2100X 24168767 VA Primary

Addresses

Primary practice location

4320 Seminary Rd
Alexandria, VA 22304-1535

Mailing address

6328 Lakewood Dr
Falls Church, VA 22041-1211
Phone (703) 354-3333

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
I20200824003462 VA Practitioner - Nurse Practitioner 6608293550 Reassigns benefits to 3 organizations
I20200908000702 DC Practitioner - Nurse Practitioner 6608293550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Palliative Care Consultants LLCGroup PAC ID 8022902600, 4 clinicians

Practice addresses (Care Compare)

3180 Fairview Park Dr
Suite 500
Falls Church, VA 22042-4583
Phone (703) 538-2066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1203038VAMDCritical Care Medicine Registered Nurse
24168767VAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Critical Care PLLC CurrentSince Jun 24, 2022 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients

Locations

10716 Richmond Hwy
Ste 204
Lorton, VA 22079

2300 Opitz Blvd
Woodbridge, VA 22191
Phone (703) 523-1000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1266969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1649592148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6328 LAKEWOOD DR",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220411211",
            "telephone_number": "703-354-3333"
        },
        {
            "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": "703-504-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "SUSAN",
        "middle_name": "RICHARDS",
        "credential": "MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-24",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "VA",
            "license": "1203038",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "24168767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.