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NPI Code Detail

MEDICARE: FIVE STAR HOUSE CALLS LLC

MEDICARE: FIVE STAR HOUSE CALLS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP2300XPrimary Care Nurse Practitioner

General Provider Information

NPI Number : 1730043506
Entity Type Code : Organization
Provider Name (Legal Business Name) : FIVE STAR HOUSE CALLS LLC
Provider Business Mailing Address
First Line : 14420 ALBEMARLE POINT PL STE 150
Second Line :
City : CHANTILLY
State : VA
Zip : 20151-1690
Country : US
Telephone Number : 703-436-0150
Fax Number :
Provider Business Practice Location Address
First Line : 14420 ALBEMARLE POINT PL STE 150
Second Line :
City : CHANTILLY
State : VA
Zip : 20151-1690
Country : US
Telephone Number : 703-436-0150
Fax Number :
Authorized Official
Title or Position : CEO
Name : JOHNNY WILKINSON
Credential :
Telephone Number : 703-436-0150
Provider Enumeration Date : 12/15/2025
Last Update Date : 04/28/2026

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Directions to “FIVE STAR HOUSE CALLS LLC ” Practice Location

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