NPIMap

Organization Active NPI

Joanne Crenshaw, MD PC

  • Ophthalmology Physician
  • Sterling, VA
National Provider Identifier
1821137738
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0101057318 Issued in VA
Legal business name
JOANNE CRENSHAW, MD PC
Practice address
21135 Whitfield Place
Suite 102
Sterling, VA 20165-7279
Phone
(703) 766-6165
Fax
(703) 444-4985
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Authorized official

Name
Joanne Crenshaw, MDNPI 1225120538
Title
Owner
Phone
(703) 766-6165

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 0101057318 VA Primary

Addresses

Primary practice location

21135 Whitfield Place
Suite 102
Sterling, VA 20165-7279

Mailing address

47568 Anchorage Circle
Potomac Falls, VA 20165-4712
Phone (703) 421-2875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080624000219 DC Part B Supplier - Clinic/Group Practice 0446321186 Receives reassigned benefits from 2 practitioners
Practice locations: Reston, VA
O20101020000152 VA Part B Supplier - Clinic/Group Practice 0446321186 Receives reassigned benefits from 3 practitioners
Practice locations: Sterling, VA

National Provider Directory

National Provider Directory

Locations

1860 Town Center Dr
Reston, VA 20190
Phone (571) 313-0349

1860 Town Center Dr
Ste G1000
Reston, VA 20190

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285804800000",
    "number": "1821137738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47568 ANCHORAGE CIRCLE",
            "city": "POTOMAC FALLS",
            "state": "VA",
            "postal_code": "201654712",
            "telephone_number": "703-421-2875",
            "fax_number": "703-421-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21135 WHITFIELD PLACE",
            "address_2": "SUITE 102",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201657279",
            "telephone_number": "703-766-6165",
            "fax_number": "703-444-4985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOANNE CRENSHAW, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2010-09-30",
        "status": "A",
        "authorized_official_last_name": "CRENSHAW",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-766-6165",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101057318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.