Susannah Obenchain Lichtenstein, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0102205029 Issued in VA

Practice address

1175 Corporate Park Dr
Forest, VA 24551-2238

Phone

(434) 525-6964

Fax

(434) 525-4035

NPI assigned

Apr 4, 2013

Last updated

Mar 27, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Sports Medicine

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
• Direct secure messaging: susannah.lichtenstein.1@8042.direct.athenahealth.com

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.

• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Nova Physician Wellness Center PLLC

  • Family Medicine Physician
  • Fairfax, VA
  • NPI 1215307400
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1902149230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 CORPORATE PARK DR",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512238",
            "telephone_number": "434-525-6964",
            "fax_number": "434-525-4035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 CORPORATE PARK DR",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512238",
            "telephone_number": "434-525-6964",
            "fax_number": "434-525-4035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Wake Forest Family Medicine Residency",
            "address_2": "Medical Center Boulevard",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271571084",
            "country_code": "US",
            "telephone_number": "336-716-2832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICHTENSTEIN",
        "first_name": "SUSANNAH",
        "middle_name": "OBENCHAIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-04",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102205029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Patricia Lefevre, PT, DPT, CSCS
• James Alexander Lenhart, PHARMD
• Lewis Support Services LLC
• Sunshine Barlowe Lewis, CD,(DONA)
• Christopher Thomas Libbey, D.D.S
• Life Lines Residential Services
• Light Counseling, Inc.
• William Blaine Likins III, DC
• Little Munchers LLC
• Lotus Counseling LLC

• Family Medicine Physician in Forest, VA
• Providers in Forest, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.