Individual provider Active NPI

Renee L Roberts, RN, MSN, WHNP-BC

  • Women's Health Nurse Practitioner
  • Dumfries, VA
National Provider Identifier
1669954095
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
0024177132 Issued in VA
Practice address
4222 Fortuna Center Plaza Ste 280
Dumfries, VA 22025
Phone
(240) 289-3887
NPI assigned
Sep 1, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001278906 VA
Women's Health Nurse Practitioner 363LW0102X 0024177132 VA Primary

Addresses

Primary practice location

4222 Fortuna Center Plaza Ste 280
Dumfries, VA 22025

Mailing address

4222 Fortuna Center Plaza Ste 280
Dumfries, VA 22025
Phone (240) 289-3887

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)
Enrolled
Credentials
Master of Science - Nursing, Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1535760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1669954095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4222 FORTUNA CENTER PLAZA STE 280",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "22025",
            "telephone_number": "240-289-3887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4222 FORTUNA CENTER PLAZA STE 280",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "22025",
            "telephone_number": "240-289-3887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "RENEE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "RN, MSN, WHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-01",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001278906",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "VA",
            "license": "0024177132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dumfries, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; 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.