Individual provider Active NPI

Leigh Ann Tubaugh, ANP-BC

  • Adult Health Nurse Practitioner
  • Herndon, VA
National Provider Identifier
1720094261
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0024183285 Issued in VA
Practice address
280 Sunset Park Dr Ste 12
Herndon, VA 20170-5219
Phone
(704) 779-6230
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APN2452 SC
Adult Health Nurse Practitioner 363LA2200X 5002184 NC
Adult Health Nurse Practitioner 363LA2200X 0024183285 VA Primary

Addresses

Primary practice location

280 Sunset Park Dr Ste 12
Herndon, VA 20170-5219

Mailing address

5307 Greyfriar CT
Waxhaw, NC 28173-6710
Phone (704) 779-6230

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
I20221102000052 DC Practitioner - Nurse Practitioner 6305759556 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2047WIMDMedical Physician Assistant
APN2452SCMDAcute Care Nurse Practitioner
5002184NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Jul 15, 2022 Accepting new patients
Privia Medical Group, LLC CurrentSince Jul 15, 2022 Accepting new patients
Wisconsin Heart Group Past Accepting new patients
Wisconsin Heart Group Associates LLC Past Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

280 Sunset Park Dr
Ste 12
Herndon, VA 20170
Phone (704) 779-6230

Interoperability endpoints

  • Direct secure messaging: leigh.ann.tubaugh.1@8042.direct.athenahealth.com

Organizations & group practices 4

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1720094261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5307 GREYFRIAR CT",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281736710",
            "telephone_number": "704-779-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 SUNSET PARK DR STE 12",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705219",
            "telephone_number": "704-779-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUBAUGH",
        "first_name": "LEIGH",
        "middle_name": "ANN",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "APN2452",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5002184",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024183285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

Verify at the official NPI Registry.