Ann L Komelasky, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0001069512 Issued in VA

Practice address

11730 Sudley Manor Drive
Manassas, VA 20109-2843

Phone

(703) 257-3001

Fax

(703) 257-3133

NPI assigned

Dec 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720156128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP",
            "address_2": "2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNIT 6 W",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-6660",
            "fax_number": "301-816-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11730 SUDLEY MANOR DRIVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092843",
            "telephone_number": "703-257-3001",
            "fax_number": "703-257-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMELASKY",
        "first_name": "ANN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0001069512",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024069512",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louis I. Koff, D.C.
• Tara B Koff, D.C.
• Smriti Koirala
• Aruna Radha Mani Kola, M.D.
• Lindsay Marie Koleny, OTR/L
• Christine S Kopp, SLP
• Rochelle Koroma
• Julie Korona
• Shruti Kishorbhai Kotak, PT
• Anna Brawley Kovalich, CCC-SLP

• Nurse Practitioner in Manassas, VA
• Providers in Manassas, VA by specialty
• Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.