Individual provider Active NPI

Nardos Tenaw

  • Psychiatric/Mental Health Nurse Practitioner
  • Gainesville, VA
National Provider Identifier
1720714215
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024191812 Issued in VA
Practice address
7110 Heritage Village PLZ
Gainesville, VA 20155-3075
Phone
(571) 556-8205
Fax
(833) 428-8384
NPI assigned
Jul 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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 T500-622-027-288 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024191812 VA Primary

Addresses

Primary practice location

7110 Heritage Village PLZ
Gainesville, VA 20155-3075

Mailing address

7110 Heritage Village PLZ
Gainesville, VA 20155-3075
Phone (301) 755-7961

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
I20241231001323 VA Practitioner - Nurse Practitioner 0648707786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Conquest HealthGroup PAC ID 9537600424, 3 clinicians

Practice addresses (Care Compare)

15100 Washington St
Suite 103
Haymarket, VA 20169-4919

7110 Heritage Village PLZ
Suite 101
Gainesville, VA 20155-3076
Phone (571) 556-8205

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T500-622-027-288MDMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Conquest Health Psychiatric/Mental Health CurrentSince Dec 1, 2024 Accepting new patients

Locations

7110 Heritage Village Plz
Ste 101
Gainesville, VA 20155
Phone (571) 248-2985

15100 Washington St
Ste 103
Haymarket, VA 20169
Phone (703) 249-9835

Interoperability endpoints

  • Direct secure messaging: nardos.tenaw.1@32501.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1720714215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7110 HERITAGE VILLAGE PLZ",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553075",
            "telephone_number": "301-755-7961",
            "fax_number": "833-428-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 HERITAGE VILLAGE PLZ",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553075",
            "telephone_number": "571-556-8205",
            "fax_number": "833-428-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENAW",
        "first_name": "NARDOS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-27",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "T500-622-027-288",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024191812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, VA

Sources for this page

Verify at the official NPI Registry.