MARY JUNE C SO – Psychiatric/Mental Health Nurse Practitioner, NPI 1609258946
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MARY JUNE C SO
9707 Key West Ave Ste 100
Rockville, MD 208503992
Phone: (240) 750-6467
Type: Location
3300 GALLOWS RD
FALLS CHURCH, VA 220423307
Phone:
Type: Mailing
9707 KEY WEST AVE STE 100
ROCKVILLE, MD 208503992
Phone: (240) 750-6467
Type: Location
1307 Vincent Pl
Mc Lean, VA 221013680
Phone: (703) 821-1073
Type: Location
1307 VINCENT PL
MC LEAN, VA 221013680
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $101.
Total Amount is formed as General ($101) + Research ($0) + Ownership ($0) = $101.
Last reported payment date: 2024-04-18 • Largest payer in this snapshot: Tris Pharma Inc ($101).
Total Amount
$101
General + Research + Ownership
Payments
1
Total payment records
General Amount
$101
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Tris Pharma Inc | $101 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-09-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150911001953 | I | Nurse Practitioner | DC | TBD |
| I20151005000837 | I | Nurse Practitioner | VA | TBD |
| I20190910001250 | I | Nurse Practitioner | MD | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 20850)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | VA | |
| - | VA | |
| Internal Medicine, Pulmonary Disease | MD | |
| - | VA | |
| - | MD | |
| - | VA | |
| - | VA | |
| - | MD | |
| Physician Assistant | VA | |
| Physician Assistant | MI |
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