Individual provider Active NPI

Carol Hodgson, NP

  • Adult Health Nurse Practitioner
  • Lovettsville, VA
National Provider Identifier
1780792473
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0024165054 Issued in VA
Practice address
11820 Berlin Tpke
Lovettsville, VA 20180-1830
Phone
(703) 431-1678
Fax
(540) 822-5030
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0024165054 VA Primary

Addresses

Primary practice location

11820 Berlin Tpke
Lovettsville, VA 20180-1830

Mailing address

11820 Berlin Tpke
Lovettsville, VA 20180-1830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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
I20180815000049 DC Practitioner - Nurse Practitioner 5597942219 Reassigns benefits to 1 organization
I20180928000176 VA Practitioner - Nurse Practitioner 5597942219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

9642 Burke Lake Rd
Burke, VA 22015-3052
Phone (703) 543-7920

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024165054VAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rahel G. Yirga MD PC CurrentSince Jun 30, 2018 Accepting new patients

Locations

6035 Burke Centre Pkwy
Ste 390
Burke, VA 22015
Phone (703) 978-0756

20 Pidgeon Hill Dr
Ste 208
Sterling, VA 20165
Phone (703) 539-6029

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1780792473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11820 BERLIN TPKE",
            "city": "LOVETTSVILLE",
            "state": "VA",
            "postal_code": "201801830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11820 BERLIN TPKE",
            "city": "LOVETTSVILLE",
            "state": "VA",
            "postal_code": "201801830",
            "telephone_number": "703-431-1678",
            "fax_number": "540-822-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGSON",
        "first_name": "CAROL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024165054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lovettsville, VA

Sources for this page

Verify at the official NPI Registry.