Individual provider Active NPI

Susan Wilkinson, CRNA

  • Certified Registered Nurse Anesthetist
  • Reston, VA
National Provider Identifier
1861471492
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024136054 Issued in VA
Practice address
1850 Town Center Parkway
Reston Hospital Center
Reston, VA 20190
Phone
(703) 471-0919
Fax
(703) 742-9081
NPI assigned
Jan 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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 0001136054 VA
Certified Registered Nurse Anesthetist 367500000X 0024136054 VA Primary

Addresses

Primary practice location

1850 Town Center Parkway
Reston Hospital Center
Reston, VA 20190

Mailing address

PO Box 2757
Reston, VA 20195
Phone (703) 471-0919

Other identifiers 2

IdentifierTypeStateIssuer
009552065MedicaidVA
430022784OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110113000377 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0244429850 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001136054VAMDRegistered Nurse
0024136054VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Reston Anesthesia Associates, PC CurrentSince Sep 15, 2000 Accepting new patients

Locations

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1861471492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2757",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20195",
            "telephone_number": "703-471-0919",
            "fax_number": "703-742-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 TOWN CENTER PARKWAY",
            "address_2": "RESTON HOSPITAL CENTER",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20190",
            "telephone_number": "703-471-0919",
            "fax_number": "703-742-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "SUSAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-12",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001136054",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024136054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009552065",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430022784",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.