Individual provider Active NPI

Kathleen D Liermann, CRNA

  • Certified Registered Nurse Anesthetist
  • Alexandria, VA
National Provider Identifier
1821260571
Registry record updated Dec 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024168046 Issued in VA
Practice address
4320 Seminary Rd
Alexandria, VA 22304-1535
Phone
(202) 577-8337
NPI assigned
Apr 1, 2008
Last updated
Dec 18, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN544477 CA
Certified Registered Nurse Anesthetist 367500000X 0024168046 VA Primary

Addresses

Primary practice location

4320 Seminary Rd
Alexandria, VA 22304-1535

Mailing address

PO Box 37090
Baltimore, MD 21297-3090
Phone (202) 577-8337

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090212000027 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810076213 Reassigns benefits to 1 organization
I20171025002436 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810076213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Old Dominion Anesthesia LLCGroup PAC ID 8820462765, 57 clinicians

Practice addresses (Care Compare)

1939 Roland Clarke PL
Suite 200
Reston, VA 20191-1445
Phone (703) 766-2650

8140 Ashton Ave
Suite 212
Manassas, VA 20109-5701
Phone (703) 365-9085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN544477CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Old Dominion Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 30, 2024 Accepting new patients

Locations

9500 S Dadeland Blvd
Ste 200
Miami, FL 33156
Phone (786) 530-3820

1800 N Beauregard St
Ste 200
Alexandria, VA 22311
Phone (703) 823-3750

3914 Centreville Rd
Ste 350
Chantilly, VA 20151
Phone (703) 263-3393

1139 E High St
Ste 105
Charlottesvle, VA 22902
Phone (434) 817-8484

8140 Ashton Ave
Ste 212
Manassas, VA 20109
Phone (703) 365-9085

1939 Roland Clarke Pl
Ste 200
Reston, VA 20191
Phone (703) 435-3366

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, 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": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229558400000",
    "number": "1821260571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37090",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973090",
            "telephone_number": "202-577-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 SEMINARY RD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041535",
            "telephone_number": "202-577-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIERMANN",
        "first_name": "KATHLEEN",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "RN544477",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024168046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.