Individual provider Active NPI

Louise A Leblanc, LNP

  • Adult Health Nurse Practitioner
  • Centreville, VA
National Provider Identifier
1679755425
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0017136834 Issued in VA
Practice address
5895 Trinity Pkwy
Suite 100
Centreville, VA 20120-1995
Phone
(703) 802-2004
NPI assigned
Dec 4, 2007
Last updated
Oct 6, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0024164061 VA
Adult Health Nurse Practitioner 363LA2200X 0017136834 VA Primary

Addresses

Primary practice location

5895 Trinity Pkwy
Suite 100
Centreville, VA 20120-1995

Mailing address

5895 Trinity Pkwy
Suite 100
Centreville, VA 20120-1995
Phone (703) 802-2004

Other identifiers 1

IdentifierTypeStateIssuer
0017136834OtherVAAUTH TO PRESCRIBE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20140827000371 DC Order and Referring Only - Nurse Practitioner 9830317239

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0017136834VAMDAdult Health Nurse Practitioner
0024164061VAMDAdult Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: louise.leblanc.1@17938.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1679755425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5895 TRINITY PKWY",
            "address_2": "SUITE 100",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201201995",
            "telephone_number": "703-802-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5895 TRINITY PKWY",
            "address_2": "SUITE 100",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201201995",
            "telephone_number": "703-802-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "LOUISE",
        "middle_name": "A",
        "credential": "LNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-04",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024164061",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0017136834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUTH TO PRESCRIBE LICENSE",
            "identifier": "0017136834",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, VA

Sources for this page

Verify at the official NPI Registry.