Individual provider Active NPI

Rebekah Hannay Jordan

  • Family Nurse Practitioner
  • Ashburn, VA
National Provider Identifier
1659618049
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024170557 Issued in VA
Practice address
21170 Ashby Ponds Blvd
Ashburn, VA 20147-6128
Phone
(571) 291-6131
Fax
(571) 291-6135
NPI assigned
Jan 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 0024170557 VA Primary

Addresses

Primary practice location

21170 Ashby Ponds Blvd
Ashburn, VA 20147-6128

Mailing address

5525 Research Park Dr FL 4
Baltimore, MD 21228-4873
Phone (571) 291-6131

Other practice location 1

44045 Riverside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-6044

Other names 1

  • Rebekah Susanne Hannay Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130326000258 VA Practitioner - Nurse Practitioner 6002051935 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024170557VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Nov 7, 2018 Accepting new patients
Commonwealth Emergency Physicians PC CurrentSince Feb 1, 2013 Accepting new patients
Sharon Shavit CurrentSince Jul 1, 2024 Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 7, 2018 Accepting new patients
Jonathan D Smith, DC, PC Past Accepting new patients
Erickson Health Medical Group of Virginia PC Past Accepting new patients
Commonwealth Emergency Physicians PC PastSince Apr 17, 2020 Accepting new patients

Locations

100 Chalmers Ct
Berryville, VA 22611
Phone (540) 692-9428

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

8644 Sudley Rd
#220
Manassas, VA 20110

Organizations & group practices 7

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": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659618049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 RESEARCH PARK DR FL 4",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212284873",
            "telephone_number": "571-291-6131",
            "fax_number": "571-291-6135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21170 ASHBY PONDS BLVD",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201476128",
            "telephone_number": "571-291-6131",
            "fax_number": "571-291-6135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44045 Riverside Pkwy",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201765101",
            "country_code": "US",
            "telephone_number": "703-858-6044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "REBEKAH",
        "middle_name": "HANNAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024170557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBEKAH",
            "last_name": "HANNAY",
            "middle_name": "SUSANNE",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ashburn, VA

Sources for this page

Verify at the official NPI Registry.