Individual provider Active NPI

Daphne C Jenkins, FNP-BC

  • Family Nurse Practitioner
  • McLean, VA
National Provider Identifier
1659439651
Registry record updated Sep 24, 2021
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Sep 19, 2024.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024164470 Issued in VA
Practice address
1452 Chain Bridge Rd
MC Lean, VA 22101-3706
Phone
(866) 389-2727
NPI assigned
Dec 4, 2006
Last updated
Sep 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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 0024164470 VA Primary

Addresses

Primary practice location

1452 Chain Bridge Rd
MC Lean, VA 22101-3706

Mailing address

3695 Ketchum CT
Woodbridge, VA 22193-1064
Phone (703) 955-6695

Other practice location 1

3695 Ketchum Ct
Woodbridge, VA 22193-1064
Phone (703) 955-6695

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024164470VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Wellness Telemed PLLC Family CurrentSince Sep 12, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1659439651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3695 KETCHUM CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221931064",
            "telephone_number": "703-955-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1452 CHAIN BRIDGE RD",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013706",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3695 Ketchum Ct",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "221931064",
            "country_code": "US",
            "telephone_number": "703-955-6695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "DAPHNE",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024164470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

Verify at the official NPI Registry.