Mary Erhunmwunse

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0024182565 Issued in VA

Practice address

3650 Joseph Siewick Dr
Fairfax, VA 22033-1710

Phone

(703) 758-8800

NPI assigned

Aug 26, 2021

Last updated

Aug 26, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pavilion Medical Home Care & Staffing, LLC

  • Home Health Agency
  • Annandale, VA
  • NPI 1376620120
  NPD

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1922775964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 JOSEPH SIEWICK DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331710",
            "telephone_number": "703-758-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 JOSEPH SIEWICK DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331710",
            "telephone_number": "703-758-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERHUNMWUNSE",
        "first_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024182565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ikay Kanayo Enu, MD
• Enviro-Enterprises LLC (Enviro-Ride)
• Dian B Epp, LCSW, CAC
• Kelly Charrise Epps-Anderson, MD
• Alexis Tite'Anna Epps
• Eric J W Choe MD PC
• Dana W. Ericksen, DDS
• Erickson Health Medical Group of Virginia, PC
• Yvi Erickson
• Alicia Ann Ericson, CPO

• Nurse Practitioner in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.