Hanieh Khorshidi, BSN, AGNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

0024172715 Issued in VA

Practice address

10220 River Rd Ste 4
Potomac, MD 20854-4907

Phone

(703) 400-3866

NPI assigned

Jul 7, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1912380155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 WALKER RD",
            "city": "GREAT FALLS",
            "state": "VA",
            "postal_code": "220663507",
            "telephone_number": "703-400-3866",
            "fax_number": "703-671-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10220 RIVER RD STE 4",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208544907",
            "telephone_number": "703-400-3866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 S Carlin Springs Rd",
            "address_2": "suite 409",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222041064",
            "country_code": "US",
            "telephone_number": "703-671-8444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHORSHIDI",
        "first_name": "HANIEH",
        "name_prefix": "Mrs.",
        "credential": "BSN, AGNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024172715",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VA",
            "license": "0024172715",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024172715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Potomac, MD
• Providers in Potomac, MD by specialty
• Adult Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.