FAIRFAX NURSING CENTER, INC (NPI# 1386636116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386636116 |
| Entity Type | Organization |
| Organization Name | FAIRFAX NURSING CENTER, INC |
| Practice Address |
10701 Main St Fairfax VA 22030-6904 |
| Practice Telephone | 7032737705 |
| Practice Fax Number | 7032739066 |
| Mailing Telephone | 7032737705 |
| Mailing Fax Number | 7032738077 |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2015-08-07 |
| Authorized Official Name | MS. RENEE BAINUM CARLSON (EXECUTIVE ADMINISTRATOR) |
| Authorized Official Telephone | 7032737705 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NH2552 | VA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MC B DME PROVIDER NUMBER | 0573480001 | 01 |
| VA | 004950992 | 05 | |
| VA | ANTHEM BC/BS PROVIDER NO. | 442051 | 01 |
| Street Address |
10701 MAIN ST |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-6904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718382 | Fairfax Operator LLC | Skilled Nursing Facility | 10701 Main St, Fairfax, VA 22030-6904 | 2020-10-19 |
| 1336751551 | Hannah Pagsibigan Perlman | Physical Therapy Assistant | 10701 Main St, Fairfax, VA 22030-6995 | 2020-08-19 |
| 1356952865 | Nathan Louis Slade | Physical Therapy Assistant | 10701 Main St, Fairfax, VA 22030-6904 | 2020-08-10 |
| 1063039337 | Katherine Mary Garity | Registered Nurse | 10701 Main St, Fairfax, VA 22030-6904 | 2020-07-02 |
| 1043833072 | Seth Noble | Nurse's Aide | 10701 Main St, Fairfax, VA 22030-6904 | 2020-05-26 |
| 1164056271 | Mediwounds International Inc | Family Medicine | 10701 Main St, Fairfax, VA 22030-6904 | 2020-02-27 |
| 1598313637 | Sandra Wright | Nurse Practitioner | 10701 Main St, Fairfax, VA 22030-6904 | 2019-09-02 |
| 1235791872 | Nadia Ramadhin | Speech-Language Pathologist | 10701 Main St, Fairfax, VA 22030-6904 | 2019-07-03 |
| 1225696784 | Tiffany Chen | Occupational Therapist | 10701 Main St, Fairfax, VA 22030-6904 | 2019-05-30 |
| 1194381178 | Mayura Jayant Rane | Occupational Therapy Assistant | 10701 Main St, Fairfax, VA 22030-6904 | 2019-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1659418473 | Caremeridian, LLC | Skilled Nursing Facility | 2390 Sir Francis Drake Blvd, Fairfax, CA 94930-1127 | 2007-01-31 |
| 1336246677 | Allendale County Hospital Board | Skilled Nursing Facility | 185 Revolutionary Trail, Fairfax, SC 29827 | 2006-09-20 |
| 1861437154 | Manor Care-fair Oaks of Fairfax Va LLC | Skilled Nursing Facility | 12475 Lee Jackson Memorial Hwy, Fairfax, VA 22033-2803 | 2006-06-19 |
| 1710963251 | Fairfax Community Home Inc | Skilled Nursing Facility | 300 10th Ave Se, Fairfax, MN 55332-2149 | 2005-12-16 |
| 1972592533 | The Temple Foundation Inc. | Skilled Nursing Facility | 9229 Arlington Blvd, Fairfax, VA 22031-2504 | 2005-10-17 |
| 1033718382 | Fairfax Operator LLC | Skilled Nursing Facility | 10701 Main St, Fairfax, VA 22030-6904 | 2020-10-19 |
| 1912032012 | Inova Health System Services | Skilled Nursing Facility | 4315 Chain Bridge Rd, Fairfax, VA 22030-3061 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760015119 | Mikaylah Lang | Skilled Nursing Facility | 4505 Georgewashington Hwy, Portsmouth, VA 23702 | 2020-02-13 |
| 1134760432 | Valley Operator LLC | Skilled Nursing Facility | 940 E Lee Hwy, Chilhowie, VA 24319-3237 | 2019-10-08 |
| 1871134171 | Westport Operator LLC | Skilled Nursing Facility | 7300 Forest Ave, Richmond, VA 23226-3735 | 2019-10-08 |
| 1437790730 | Hopewell Operator LLC | Skilled Nursing Facility | 905 Cousins Ave, Hopewell, VA 23860-6507 | 2019-10-08 |
| 1013478411 | Blue Ridge Snf Operations LLC | Skilled Nursing Facility | 105 Landmark Dr, Stuart, VA 24171-9401 | 2019-03-28 |
| 1265924260 | Nassawadox Life Care, LLC | Skilled Nursing Facility | 9468 Hospital Road, Nassawadox, VA 23413-0176 | 2018-06-05 |
| 1518459593 | Big Stone Gap Life Care, LLC | Skilled Nursing Facility | 2045 Valley View Dr, Big Stone Gap, VA 24219-3319 | 2018-06-05 |
| 1538600036 | Prince William H&r Ops Limited Partnership | Skilled Nursing Facility | 14935 Holly Knoll Lane, Gainesville, VA 20155 | 2017-03-16 |
| 1033660360 | Nathan Ian Dalleave | Skilled Nursing Facility | 1243 Lanier Rd, Martinsville, VA 24112-5211 | 2016-10-21 |
| 1669823373 | Allyson Clark | Skilled Nursing Facility | 490 Paradise Ln, Saxe, VA 23967-5529 | 2016-06-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.