Individual provider Active NPI

Stephanie Leigh Ryan, NP

  • Pediatric Nurse Practitioner
  • Fairfax, VA
National Provider Identifier
1992401996
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024186370 Issued in VA
Practice address
8081 Innovation Park Dr Ste 765
Fairfax, VA 22031-4867
Phone
(571) 472-1717
NPI assigned
Feb 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0024186370 VA Primary

Addresses

Primary practice location

8081 Innovation Park Dr Ste 765
Fairfax, VA 22031-4867

Mailing address

8081 Innovation Park Dr Ste 765
Fairfax, VA 22031-4867

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230807000811 DC Practitioner - Nurse Practitioner 1153782156 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital CurrentSince Feb 28, 2024 Accepting new patients
Inova Health Care Services Current Accepting new patients
Inova Health Care Services CurrentSince Apr 25, 2023 Accepting new patients
Children'S Hospital Current Accepting new patients
Children'S Hospital CurrentSince Feb 28, 2024 Accepting new patients
Inova Health Care Services CurrentSince Apr 25, 2023 Accepting new patients
Pediatric Specialists of Virginia, LLC CurrentSince Apr 25, 2023 Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

3023 Hamaker Ct
Ste 400
Fairfax, VA 22031
Phone (571) 226-8380

8081 Innovation Park Dr
Ste 765
Fairfax, VA 22031
Phone (571) 472-1717

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

Organizations & group practices 7

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": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1992401996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8081 INNOVATION PARK DR STE 765",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 INNOVATION PARK DR STE 765",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314867",
            "telephone_number": "571-472-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "STEPHANIE",
        "middle_name": "LEIGH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024186370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.