Individual provider Active NPI

Mary Jamison

  • Family Nurse Practitioner
  • Washington, DC
National Provider Identifier
1821415472
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024170815 Issued in VA
Practice address
1050 Connecticut Ave NW Ste 500
Washington, DC 20036-5304
Phone
(202) 596-8891
Fax
(833) 941-2357
NPI assigned
Mar 20, 2014
Last updated
Nov 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024170815 VA Primary
Pediatric Nurse Practitioner 363LP0200X 0024170815 VA

Addresses

Primary practice location

1050 Connecticut Ave NW Ste 500
Washington, DC 20036-5304

Mailing address

1050 Connecticut Ave NW Ste 500
Washington, DC 20036-5304
Phone (202) 596-8891

Other practice location 1

1010 Ednam Ctr Ste 209
Charlottesville, VA 22903-4624
Phone (202) 596-8891

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024170815VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Revolution Medicine Health & Fitness PLLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23388/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mary.jamison.1@23388.direct.athenahealth.com

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": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1821415472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 CONNECTICUT AVE NW STE 500",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200365304",
            "telephone_number": "202-596-8891",
            "fax_number": "833-941-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 CONNECTICUT AVE NW STE 500",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200365304",
            "telephone_number": "202-596-8891",
            "fax_number": "833-941-2357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Ednam Ctr Ste 209",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229034624",
            "country_code": "US",
            "telephone_number": "202-596-8891",
            "fax_number": "833-941-2357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMISON",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-20",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024170815",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024170815",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.