Individual provider Active NPI

Katelyn Wrenn

  • Physician Assistant
  • Leesburg, VA
National Provider Identifier
1922658194
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110006899 Issued in VA
Practice address
44035 Riverside Pkwy Ste 400
Leesburg, VA 20176-8260
Phone
(703) 858-5421
Fax
(703) 858-9573
NPI assigned
Sep 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110006899 VA Primary

Addresses

Primary practice location

44035 Riverside Pkwy Ste 400
Leesburg, VA 20176-8260

Mailing address

2901 Telestar CT Ste 300
Falls Church, VA 22042-1263
Phone (703) 591-1688

Other practice location 1

120B N Maple Ave
Purcellville, VA 20132-3180
Phone (703) 723-8664

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kwrenn643134@soc.inova.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191230001988 VA Practitioner - Physician Assistant 3678907508 Reassigns benefits to 3 organizations
I20231121003566 DC Practitioner - Physician Assistant 3678907508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

120 B N Maple Ave
Purcellville, VA 20132-3180
Phone (703) 723-8664

224 A Cornwall St NW
Suite 3.024
Leesburg, VA 20176-2701
Phone (703) 771-2837

224 B Cornwall NWST
Leesburg, VA 20176-2701

224 Cornwall St NW
Leesburg, VA 20176-2701
Phone (703) 771-2894

44035 Riverside Pkwy
Leesburg, VA 20176-8260

44045 Rivderside Pkwy
Leesburg, VA 20176-5101

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110006899VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Oct 8, 2023 Accepting new patients
Valley Physician Enterprise, Inc. CurrentSince Nov 1, 2019 Accepting new patients
Inova Health Care Services CurrentSince Oct 6, 2023 Accepting new patients
Valley Physician Enterprise, Inc. CurrentSince Nov 1, 2019 Accepting new patients
Winchester Medical Center CurrentSince Nov 1, 2019 Accepting new patients
Winchester Medical Center CurrentSince Nov 1, 2019 Accepting new patients
Inova Health Care Services CurrentSince Oct 6, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2901 Telestar Ct
Ste 300
Falls Church, VA 22042
Phone (703) 591-1688

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

1000 N Shenandoah Ave
Front Royal, VA 22630
Phone (540) 636-0300

44035 Riverside Pkwy
Ste 400
Leesburg, VA 20176
Phone (703) 858-5421

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

120B N Maple Ave
Purcellville, VA 20132
Phone (703) 723-8664

11800 Sunrise Valley Dr
Ste 225
Reston, VA 20191

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

1880 Amherst St
Ste 100
Winchester, VA 22601
Phone (540) 662-0306

220 Campus Blvd
Ste 100
Winchester, VA 22601

Organizations & group practices 10

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1922658194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 TELESTAR CT STE 300",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220421263",
            "telephone_number": "703-591-1688",
            "fax_number": "703-591-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44035 RIVERSIDE PKWY STE 400",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201768260",
            "telephone_number": "703-858-5421",
            "fax_number": "703-858-9573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120B N Maple Ave",
            "address_purpose": "LOCATION",
            "city": "Purcellville",
            "state": "VA",
            "postal_code": "201323180",
            "country_code": "US",
            "telephone_number": "703-723-8664",
            "fax_number": "703-226-5696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRENN",
        "first_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-18",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwrenn643134@soc.inova.org",
            "affiliation": "N",
            "address_1": "44035 Riverside Pkwy Ste 400",
            "city": "Leesburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201768260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.