Individual provider Active NPI

Breanna Carozza, NP

  • Women's Health Nurse Practitioner
  • Alexandria, VA
National Provider Identifier
1962941013
Registry record updated Feb 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
0024180880 Issued in VA
Practice address
4226 King St
Alexandria, VA 22302-1507
Phone
(571) 777-8938
NPI assigned
Feb 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 0024180880 VA Primary

Addresses

Primary practice location

4226 King St
Alexandria, VA 22302-1507

Mailing address

4226 King St
Alexandria, VA 22302-1507
Phone (571) 777-8938

Other names 1

  • Breanna Blair Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200115000357 DC Practitioner - Certified Nurse Midwife (CNM) 3779918099 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024180880VAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marys Center for Maternal and Child Care Inc CurrentSince Nov 19, 2019 Accepting new patients
Mary'S Center for Maternal and Child Care, Inc CurrentSince Nov 19, 2019 Accepting new patients

Locations

2333 Ontario Rd NW
Washington, DC 20009
Phone (202) 420-7175

3912 Georgia Ave NW
Washington, DC 20011
Phone (844) 796-2797

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738368000000",
    "number": "1962941013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4226 KING ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021507",
            "telephone_number": "571-777-8938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4226 KING ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021507",
            "telephone_number": "571-777-8938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAROZZA",
        "first_name": "BREANNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-21",
        "last_updated": "2025-02-01",
        "certification_date": "2025-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "VA",
            "license": "0024180880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREANNA",
            "last_name": "BLAIR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.