Individual provider Active NPI

John Iver, RN, MSN, CDP

  • Registered Nurse
  • Fairfax, VA
National Provider Identifier
1841541059
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
0001217000 Issued in VA
Practice address
10300 Eaton PL Ste 260
Fairfax, VA 22030-2255
Phone
(571) 620-7556
Fax
(571) 620-7557
NPI assigned
Sep 27, 2012
Last updated
Apr 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001217000 VA Primary
Home Health Registered Nurse 163WH0200X 0001217000 VA

Addresses

Primary practice location

10300 Eaton PL Ste 260
Fairfax, VA 22030-2255

Mailing address

10300 Eaton PL Ste 260
Fairfax, VA 22030-2255
Phone (571) 620-7556

Other practice location 1

6128 Brandon Ave Ste 222
Springfield, VA 22150-2693
Phone (571) 620-7556

Other names 1

  • John Iver Professional name

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)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001217000VAMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Premium Care USA LLC CurrentSince Jul 1, 2020 Accepting new patients

Locations

10300 Eaton Pl
Ste 260
Fairfax, VA 22030
Phone (571) 620-7556

3022 Javier Rd
Ste 152
Fairfax, VA 22031
Phone (202) 258-3344

6128 Brandon Ave
Ste 222
Springfield, VA 22150
Phone (571) 620-7556

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": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1841541059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 EATON PL STE 260",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302255",
            "telephone_number": "571-620-7556",
            "fax_number": "571-620-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 EATON PL STE 260",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302255",
            "telephone_number": "571-620-7556",
            "fax_number": "571-620-7557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6128 Brandon Ave Ste 222",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "VA",
            "postal_code": "221502693",
            "country_code": "US",
            "telephone_number": "571-620-7556",
            "fax_number": "571-620-7557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVER",
        "first_name": "JOHN",
        "credential": "RN, MSN, CDP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-27",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001217000",
            "primary": true
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "VA",
            "license": "0001217000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "IVER",
            "credential": "RN, MSN, FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.