Kathleen Anastasia Zinicola, CPNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0024171847 Issued in VA

Practice address

6230 Rolling Rd Ste I / J
Springfield, VA 22152-2307

Phone

(571) 665-6460

Fax

(571) 565-6561

NPI assigned

Jul 17, 2014

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

Other names 1

• Kathleen Anastasia Baniewicz Former name

Electronic endpoints 1

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbaniewicz155978@soc.inova.org

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.

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  • Emergency Medicine Physician
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  • NPI 1598723082
  NPD
• Inova Health Care Services

  • Urgent Care Clinic/Center
  • Vienna, VA
  • NPI 1275886418
  NPD
• Inova Health Care Services

  • Multi-Specialty Clinic/Center
  • Fairfax, VA
  • NPI 1669511051
  NPD
• Inova Health Care Services

  • Medical Technologist
  • Sterling, VA
  • NPI 1699655589
  NPD
• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061
  NPD
• Commonwealth Emergency Physicians PC

  • Physician Assistant
  • Leesburg, VA
  • NPI 1366061574

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1750798146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6230 ROLLING RD STE I / J",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221522307",
            "telephone_number": "571-665-6460",
            "fax_number": "571-565-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6230 ROLLING RD STE I / J",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221522307",
            "telephone_number": "571-665-6460",
            "fax_number": "571-565-6561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20955 Professional Plz",
            "address_2": "#200",
            "address_purpose": "LOCATION",
            "city": "Ashburn",
            "state": "VA",
            "postal_code": "201473405",
            "country_code": "US",
            "telephone_number": "703-729-7652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZINICOLA",
        "first_name": "KATHLEEN",
        "middle_name": "ANASTASIA",
        "name_prefix": "Ms.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-17",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024171847",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024171847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbaniewicz155978@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Health Care Services",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3263 Columbia Pike",
            "city": "Arlington",
            "state": "VA",
            "country_code": "US",
            "postal_code": "222044351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "BANIEWICZ",
            "middle_name": "ANASTASIA",
            "credential": "RN, CPNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Xin Zhou
• Azam Nikhah Ziari, LPTA
• Beth Ziegler
• Daniel Francis Ziegler, BCBA
• Trelawny Zimmermann, D.O.
• Monica Jane Zink, DNP-FNP-BC
• Arash Zirakzadeh
• Kaitlyn Zito, LPC
• Laney Zundel-Stenquist, LCSW
• Zylo Systems LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.

Verify at the official NPI Registry.