Individual provider Active NPI

Karynn Suzette Gomes, NP-C

  • Family Nurse Practitioner
  • Alexandria, VA
National Provider Identifier
1740970060
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024187000 Issued in VA
Practice address
3610D King St
Alexandria, VA 22302-1908
Phone
(703) 845-2815
NPI assigned
May 10, 2023
Last updated
May 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024187000 VA Primary

Addresses

Primary practice location

3610D King St
Alexandria, VA 22302-1908

Mailing address

3610D King St
Alexandria, VA 22302-1908
Phone (703) 845-2815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230808003217 DC Practitioner - Nurse Practitioner 3173985116 Reassigns benefits to 1 organization
I20230809003796 MD Practitioner - Nurse Practitioner 3173985116 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024187000VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Urgent Care LLC Current Accepting new patients
Medstar Urgent Care LLC CurrentSince Jul 2, 2023 Accepting new patients
Medstar Urgent Care LLC CurrentSince Jul 2, 2023 Accepting new patients
Medstar Urgent Care, LLC CurrentSince Jul 2, 2023 Accepting new patients

Locations

3007 Tilden St NW
Ste 5N
Washington, DC 20008

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

3610D King St
Alexandria, VA 22302
Phone (703) 845-2815

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": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1740970060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610D KING ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021908",
            "telephone_number": "703-845-2815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610D KING ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021908",
            "telephone_number": "703-845-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMES",
        "first_name": "KARYNN",
        "middle_name": "SUZETTE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024187000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.