Individual provider Active NPI

Christine Ibarguen, NP

  • Family Nurse Practitioner
  • Reston, VA
National Provider Identifier
1710949714
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024168965 Issued in VA
Practice address
1850 Town Center Pkwy
Ste 314
Reston, VA 20190-3219
Phone
(703) 481-5212
NPI assigned
Apr 5, 2006
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024168965 VA Primary
Clinical Nurse Specialist 364S00000X 0024168965 VA

Addresses

Primary practice location

1850 Town Center Pkwy
Ste 314
Reston, VA 20190-3219

Mailing address

1850 Town Center Pkwy
Ste 314
Reston, VA 20190-3219
Phone (703) 481-5212

Other identifiers 1

IdentifierTypeStateIssuer
0320552MedicaidMA

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
I20241213002730 VA Practitioner - Nurse Practitioner 2668418849 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Manbir Takhar PCGroup PAC ID 0749206951, 41 clinicians

Practice addresses (Care Compare)

22000 Dulles Retail PLZ
Suite 132
Sterling, VA 20166-2515
Phone (703) 962-4160

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024168965VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Access P.C. CurrentSince Nov 1, 2024 Accepting new patients
Tru Health Group, PC CurrentSince Nov 1, 2024 Accepting new patients
Internal Medicine Group of Northern Virginia, LTD. Current Accepting new patients
Manbir Takhar, P.C. CurrentSince Nov 1, 2024 Accepting new patients
Riverside Medical Group PC PastSince May 28, 1997 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Premier Diagnostic Services, Inc Past Accepting new patients

Locations

12321 Middlebrook Rd
Ste 102
Germantown, MD 20874
Phone (301) 428-3192

531 E Market St
Ste D
Leesburg, VA 20176
Phone (301) 427-1070

22000 Dulles Retail Plz
Ste 132
Sterling, VA 20166
Phone (703) 962-4160

Interoperability endpoints

  • Direct secure messaging: christine.ibarguen.1@20907.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1710949714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 TOWN CENTER PKWY",
            "address_2": "STE 314",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903219",
            "telephone_number": "703-481-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 TOWN CENTER PKWY",
            "address_2": "STE 314",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903219",
            "telephone_number": "703-481-5212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBARGUEN",
        "first_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024168965",
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "VA",
            "license": "0024168965",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0320552",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.