Chantilly Wellness Group, LLC
NPI 1992541890ActiveOrganization· Nurse Practitioner, Pediatrics· Chantilly, VA
Nurse Practitioner, Pediatrics in Chantilly, Virginia, registered in NPPES in July 2024. The authorized official on file is Emily Derocco, DC, Secretary. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1992541890 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 1, 2024 |
| Last updated in NPPES | Apr 28, 2025 |
| Certified by provider | Apr 28, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Pediatrics Primary | 363LP0200X | — | — |
| Obstetrics & Gynecology | 207V00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (DC) |
|---|
Other pediatric nurse practitioners in Chantilly
- 1396876520
- 1437823242
- 1497297717