NPIMap

Organization Active NPI

Drynachan LLC

  • Nurse Practitioner
  • Chantilly, VA
National Provider Identifier
1891044657
Registry record updated Mar 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
DRYNACHAN LLC
Practice address
14121 Parke Long CT
Suite 201
Chantilly, VA 20151-1647
Phone
(571) 449-3585
NPI assigned
Sep 7, 2012
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Brian J Wise
Title
Ceo
Phone
(571) 449-2928

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory

Locations

40600 Ann Arbor Rd E
Ste 201
Plymouth, MI 48170
Phone (732) 503-0312

645 Lakeland East Dr
Flowood, MS 39232

9 Capitol St
Concord, NH 03301
Phone (505) 340-5555

2700 Doolittle Dr
Ellsworth AFB, SD 57706
Phone (605) 385-3331

300 Montvue Rd
Ste 200
Knoxville, TN 37919

14121 Parke Long Ct
Ste 201
Chantilly, VA 20151
Phone (571) 449-8962

3080 Centreville Rd
Ste 200
Herndon, VA 20171
Phone (571) 449-2040

301 S Bedford St
Ste 1
Madison, WI 53703
Phone (773) 766-9444

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

14121 Parke Long CT
Suite 201
Chantilly, VA 20151-1647

Mailing address

14121 Parke Long CT
Suite 201
Chantilly, VA 20151-1647
Phone (571) 449-3585

Other identifiers 8

NPPES NPI Registry
IdentifierTypeStateIssuer
1891044657MedicaidWA
300001898MedicaidIN
1891055657MedicaidIL
500040770MedicaidMO
18159900MedicaidFL
1991044657MedicaidVA
003185092AMedicaidGA
GP7738MedicaidSC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 26, 2018.

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522022400000",
    "number": "1891044657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14121 PARKE LONG CT",
            "address_2": "SUITE 201",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511647",
            "telephone_number": "571-449-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14121 PARKE LONG CT",
            "address_2": "SUITE 201",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511647",
            "telephone_number": "571-449-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRYNACHAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-07",
        "last_updated": "2018-03-26",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "571-449-2928",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891044657",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300001898",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891055657",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500040770",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18159900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1991044657",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003185092A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP7738",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; 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.