NORTHERN VIRGINIA NEPHROLOGY ASSOCIATES PC (NPI# 1770632630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770632630 |
| Entity Type | Organization |
| Organization Name | NORTHERN VIRGINIA NEPHROLOGY ASSOCIATES PC |
| Practice Address |
8505 Arlington Blvd Ste 340 Fairfax VA 22031 |
| Mailing Address |
10882 Mimosa Place Oakton VA 22124 |
| Practice Telephone | 7032041614 |
| Practice Fax Number | 7032041826 |
| Mailing Telephone | 7032041614 |
| Mailing Fax Number | 7032041826 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2008-06-19 |
| Authorized Official Name | DR. MAGNUS K IKHINMWIN (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7032041614 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
0101057344 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 005856141 | 05 | |
| CALIFORNIA MEDICAID | XYPLA8274 | 01 | |
| FIRST HEALTH | 1121069 | 01 | |
| AMERIGROUP | 279891 | 01 | |
| ALLIANCE PPO | 289502 | 01 | |
| AARP UNITED HEALTHCARE | 5402030870 | 01 | |
| AETNA PPO | 5972317 | 01 | |
| CIGNA | 8989317 | 01 | |
| AETNA HMO | 2614802 | 01 | |
| ANTHEM | 391480 | 01 | |
| GEORGIA MEDICAID | 08492993A | 01 | |
| MEDICARE RAILROAD | 1102268673 | 01 | |
| BC CAREFIRST | F078 0001 | 01 | |
| DC | DC MEDICARE | 00B485N64 | 01 |
| VA MEDICARE | 00V069N17 | 01 | |
| GWU HP | 41838 | 01 | |
| CALIFORNIA MEDICAID | 9458135 | 01 | |
| ANTHEM | 319481 | 01 | |
| MEDICARE | 490807 | 01 |
| Street Address |
8505 ARLINGTON BLVD STE 340 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902414105 | Su Jung Kang | Dentist | 9661-c Main Street, Fairfax, VA 22031 | 2020-07-14 |
| 1346896347 | Fuling Guo | Acupuncturist | 3013 James St, Fairfax, VA 22031 | 2019-08-15 |
| 1902458797 | Kayla Callister | Psychologist | 2270 Willow Oaks Corporate Drive, Fairfax, VA 22031 | 2019-07-11 |
| 1790349801 | Fairfax Dental Esthetics | Dentist | 9621 Fairfax Blvd., Fairfax, VA 22031 | 2019-04-24 |
| 1417427675 | Kathryn Yen Ho | Speech-Language Pathologist | 8270 Willow Oaks Corporate Drive Suite 2127, Falls Church, VA 22031 | 2018-11-30 |
| 1932681376 | Joanne Towers | Physician Assistant | 3025 Hamaker Court Suite 300, Fairfax, VA 22031 | 2018-09-01 |
| 1790262020 | S Renee Dennis | Nurse Practitioner | 8316 Arlington Blvd Ste 500, Fairfax, VA 22031 | 2018-07-19 |
| 1013493451 | Elizabeth Joan Dwyer | Physician Assistant | 3023 Hamaker Ct., Suite 500, Fairfax, VA 22031 | 2018-07-18 |
| 1316432669 | Delta Pharm LLC | Pharmacy | 8316 Arlington Blvd Ste 100, Fairfax, VA 22031 | 2018-06-28 |
| 1629567656 | Laura Breeden | Acupuncturist | 3846 Lyndhurst Dr Apt 301, Fairfax, Va, VA 22031 | 2018-05-04 |
| Find all providers in zip 22031 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598080186 | Vineet Kumaar Jassal | Internal Medicine | 3930 Walnut St Ste 101, Fairfax, VA 22030-4750 | 2010-04-07 |
| 1295820827 | Kinjal Ramesh Patel | Internal Medicine | 3930 Walnut Street, Suite 101, Fairfax, VA 22030-4738 | 2006-10-03 |
| 1811995467 | Robert E Greenspan | Internal Medicine | 13135 Lee Jackson Memorial Hwy, 135, Fairfax, VA 22033-1907 | 2005-07-08 |
| 1639432198 | Nowal Al Baqui | Internal Medicine | 13135 Lee Jackson Memorial Hwy, #135, Fairfax, VA 22033-1907 | 2012-06-20 |
| 1285912857 | Caroline Kwon | Internal Medicine | 3930 Walnut St, Suite 101, Fairfax, VA 22030-4738 | 2011-07-29 |
| 1942450267 | Misbah Zaheer | Internal Medicine | 13135 Lee Jackson Memorial Hwy, Ste 135, Fairfax, VA 22033-1907 | 2008-09-23 |
| 1871778068 | Gregory Wang | Internal Medicine | 13135 Lee Jackson Memorial Hwy, #135, Fairfax, VA 22033-1907 | 2008-01-07 |
| 1487716593 | Kourosh Dibadj | Internal Medicine | 13135 Lee Jackson Memorial Hwy, 135, Fairfax, VA 22033-1907 | 2006-12-14 |
| 1700954252 | Anup Manoharan | Internal Medicine | 8316 Arlington Blvd, Suite 104, Fairfax, VA 22031-5207 | 2006-12-01 |
| 1225124779 | Renuka Sothinathan | Internal Medicine | 3930 Walnut Street, Suite 101, Fairfax, VA 22030-4738 | 2006-10-04 |
| Find all providers in FAIRFAX | ||||
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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.