CARDIAC CIN OF NORTHERN VIRGINIA LLC


Address: 1900 Campus Commons Dr Ste 100c, Reston, VA 20191-1561
Phone: 6153860064

CARDIAC CIN OF NORTHERN VIRGINIA LLC (NPI# 1659889533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1659889533
Entity Type Organization
Organization Name CARDIAC CIN OF NORTHERN VIRGINIA LLC
Practice Address 1900 Campus Commons Dr Ste 100c
Reston
VA 20191-1561
Mailing Address 102 Woodmont Blvd Ste 350
Nashville
TN 37205-2216
Practice Telephone 6153860064
Practice Fax Number 6153860067
Mailing Telephone 6153860064
Mailing Fax Number 6153860067
Enumeration Date 2018-01-13
Last Update Date 2020-02-13
Authorized Official Name EDWARD LELAND HUTTON EADIE (DIRECTOR)
Authorized Official Telephone 6157332064
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RI0011X Internal Medicine
Specialization: Interventional Cardiology
VA Allopathic & Osteopathic Physicians
Y 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
VA Allopathic & Osteopathic Physicians

Office Location

Street Address 1900 CAMPUS COMMONS DR STE 100C
City RESTON
State VA
Zip Code 20191-1561

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1275150518 Grace Andales Soistman Nurse Practitioner 11160 South Lakes Dr. Reston, Va 20191, Reston, VA 20191 2020-07-02
1790317709 Twenty Four/7 LLC Private Vehicle 11922 Winterthur Ln, 103, Reston, VA 20191 2020-02-07
1437626058 Aramesh Darvishian Dds Pllc Dentist 12040 South Lakes Dr. Suite 200, Reston, VA 20191 2018-11-01
1992282693 Ashkan Ghods Home Health 11760 Sunrise Valley Dr, #405, Reston, VA 20191 2018-07-25
1104319698 Capital Critical Care & Informatics PC Internal Medicine 11890 Sunrise Valley Dr # 442, Reston, VA 20191 2018-06-11
1063930683 Mackenzie Marie Evans Specialist/Technologist 2380 Branleigh Park Ct, Reston, VA 20191 2017-09-04
1073910345 Jane L Mahan-wiegand Dietitian, Registered 1900 Campus Commons Drive, Suite 100, Reston, VA 20191 2014-12-02
1700214293 Sonny Sunghun Kim Dentist 11876 Sunrise Valley Drive, 101, Reston, VA 20191 2013-10-22
1982036786 Stephanie Lourdes Miller Physician Assistant 12040 South Lakes Drive, Suite 207, Generations Family Practice, Reston, VA 20191 2013-08-02
1316250988 Thao Ngoc Vuong Pharmacist 1898 Winterport Cluster, Reston, VA 20191 2010-07-23
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Taxonomy Information

Taxonomy Code 207RC0000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Cardiovascular Disease

Taxonomy Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1457518367 Adam Scott Fein Internal Medicine 1850 Town Center Pkwy # 550, Reston, VA 20190-3219 2008-05-19
1386646420 Robert A. Shor Internal Medicine 1850 Town Center Pkwy, Ste 550, Reston, VA 20190-3219 2005-06-01
1992341127 Reston Medical Associates, LLC Internal Medicine 1800 Town Center Dr Ste 212, Reston, VA 20190-3238 2019-11-22
1467098137 Reston Medical Associates Internal Medicine 1800 Town Center Dr Ste 212, Reston, VA 20190-3238 2019-11-18
1174939771 Tele-physicians, P.C. Internal Medicine 1768 Business Center Dr, Suite 100, Reston, VA 20190-5324 2014-07-03
1497998231 The Cardiovascular Group, PC Internal Medicine 1850 Town Center Pkwy, #550, Reston, VA 20190-3219 2009-04-09
1932386703 Dhaval R Patel Internal Medicine 1850 Town Center Pkwy, #550, Reston, VA 20190-3219 2008-01-23
1831299783 Padma Kant Shukla Internal Medicine 1860 Town Center Dr, Suite #210, Reston, VA 20190 2006-09-22

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1407482102 Careclix Inc Internal Medicine 206 N Washington St Ste 100, Alexandria, VA 22314-2534 2020-03-14
1962046763 Southpark Vascular Center Internal Medicine 445 Charles H Dimmock Pkwy Ste 101, Colonial Heights, VA 23834-2990 2019-11-05
1205496866 United Diagnostic Services LLC Internal Medicine 4115 Annandale Rd Ste 301d, Annandale, VA 22003-2500 2019-06-17
1790348365 Virginia Hospital Center Physician Group LLC Internal Medicine 1625 N George Mason Dr Ste 354, Arlington, VA 22205-3687 2019-04-18
1366905523 Premier Cardiac and Vascular LLC Internal Medicine 5514 Alma Ln Ste 200, Springfield, VA 22151-4014 2019-04-12
1083133144 Community Cardiology Internal Medicine 43 Rives Rd Ste 201, Petersburg, VA 23805-9255 2017-09-11
1306361803 Stateline Heart and Vascular Health, Inc Internal Medicine 312 Fairy Street Ext Ste 101, Martinsville, VA 24112-1912 2017-08-07
1265954747 Sentara Medical Group Internal Medicine 1933 Edwin Dr Ste 208a, Chesapeake, VA 23322-6531 2017-07-17
1003366618 Bluefield Vascular Center Internal Medicine 970 Leatherwood Ln, Bluefield, VA 24605-2047 2016-10-06
1770947806 Rajiv Ashok Kabadi Internal Medicine Vcuhs Department of Cards Fellowship, 980509, 1250 E. Marshall Street, Richmond, VA 23298-0509 2016-04-05
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City RESTON
Zip Code 20191

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Dataset Information

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.

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