Individual provider Active NPI

Ellie Landry

  • Family Nurse Practitioner
  • Lynchburg, VA
National Provider Identifier
1982384319
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024187489 Issued in VA
Practice address
1606 Regents Parkway
Lynchburg, VA 24502
Phone
(434) 338-7774
NPI assigned
Jul 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024187489 VA Primary

Addresses

Primary practice location

1606 Regents Parkway
Lynchburg, VA 24502

Mailing address

1000 Misty Mountain Rd Apt 104
Lynchburg, VA 24502-3947
Phone (757) 784-2688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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
I20240625001389 DC Practitioner - Nurse Practitioner 5193268639 Reassigns benefits to 1 organization
I20240725001904 VA Practitioner - Nurse Practitioner 5193268639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

527 Pocket Rd
Hurt, VA 24563-2023
Phone (434) 324-9150

8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024187489VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Apr 15, 2024 Accepting new patients
Privia Medical Group, LLC CurrentSince Apr 15, 2024 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

8644 Sudley Rd
#220
Manassas, VA 20110

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: ellie.landry.1@8042.direct.athenahealth.com

Organizations & group practices 3

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": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1982384319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MISTY MOUNTAIN RD APT 104",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245023947",
            "telephone_number": "757-784-2688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 REGENTS PARKWAY",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "24502",
            "telephone_number": "434-338-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "ELLIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-20",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024187489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.