Chantilly Wellness Group, LLC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

Legal business name

CHANTILLY WELLNESS GROUP, LLC

Practice address

4200A Technology CT
Chantilly, VA 20151-1214

Phone

(540) 709-1737

Fax

(866) 611-3615

NPI assigned

Jul 1, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Emily Derocco, DCNPI 1588941207

Title

Secretary

Phone

(620) 504-2434

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rodolfo Hector Gonzalez, M.D.

  • Specialist
  • Reston, VA
  • NPI 1508955964

  DC

  Medicare reassignment NPD
• Emily Derocco, D.C.

  • Pediatric Chiropractor
  • Chantilly, VA
  • NPI 1588941207
  NPD Authorized official
• Betsy Novotny, CPNP

  • Pediatric Nurse Practitioner
  • Monterey, CA
  • NPI 1033402300

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1992541890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200A TECHNOLOGY CT",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511214",
            "telephone_number": "540-709-1737",
            "fax_number": "866-611-3615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200A TECHNOLOGY CT",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511214",
            "telephone_number": "540-709-1737",
            "fax_number": "866-611-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANTILLY WELLNESS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-01",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A",
        "authorized_official_last_name": "DEROCCO",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "620-504-2434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chantilly Modern Dentistry, PC
• Chantilly Specialists, LTD.
• Chantilly Specialists, LTD. of Virginia
• Chantilly Specialists, LTD. of Virginia
• Chantilly Speech Therapy, LLC
• Hongying Chen, DPT, PT
• Si Chen
• Chentilly Acupuncture LLC
• Emily Chepkemoi
• Kimberly Cherayil

• Pediatric Nurse Practitioner in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Pediatric Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.