Active NPI
Susan Lee Russo, C.N.M.
- Advanced Practice Midwife
- Fairfax, VA
National Provider Identifier
1962493866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 0024094866
- Practice address
- 4001 Fair Ridge Dr
Suite 303
Fairfax, VA 22033-2917 - Phone
- (703) 359-4842
- NPI assigned
- Oct 31, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 0024094866 | VA | Primary |
Addresses
Primary practice location
4001 Fair Ridge Dr
Suite 303
Fairfax, VA 22033-2917
Mailing address
3701 Fiery Run Rd
Linden, VA 22642-1831
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024094866 | VA | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1962493866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3701 FIERY RUN RD",
"city": "LINDEN",
"state": "VA",
"postal_code": "226421831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 FAIR RIDGE DR",
"address_2": "SUITE 303",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220332917",
"telephone_number": "703-359-4842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "SUSAN",
"middle_name": "LEE",
"credential": "C.N.M.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-31",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "VA",
"license": "0024094866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.