Active NPI
Susan Wilkinson, CRNA
- Certified Registered Nurse Anesthetist
- Reston, VA
National Provider Identifier
1861471492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 0024136054
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009552065 | Medicaid | VA | |
| 430022784 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0001136054 | VA | MD | Registered Nurse |
| 0024136054 | VA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reston Anesthesia Associates, PC | Current | 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.