Active NPI
Mary Gaffney, NP
- Nurse Practitioner
- Vienna, VA
National Provider Identifier
1720864564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 0024187820
- Practice address
- 853 Shady Dr SE
Vienna, VA 22180-5990 - Phone
- (630) 388-8355
- NPI assigned
- Sep 7, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 0024187820 | VA | Primary |
Addresses
Primary practice location
853 Shady Dr SE
Vienna, VA 22180-5990
Mailing address
853 Shady Dr SE
Vienna, VA 22180-5990
Phone (630) 388-8355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1720864564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "853 SHADY DR SE",
"city": "VIENNA",
"state": "VA",
"postal_code": "221805990",
"telephone_number": "630-388-8355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "853 SHADY DR SE",
"city": "VIENNA",
"state": "VA",
"postal_code": "221805990",
"telephone_number": "630-388-8355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAFFNEY",
"first_name": "MARY",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-07",
"last_updated": "2023-09-07",
"certification_date": "2023-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "VA",
"license": "0024187820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vienna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.