SUMMIT PEDIATRIC REHAB OF NO. VA, P.C. (NPI# 1851592182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851592182 |
| Entity Type | Organization |
| Organization Name | SUMMIT PEDIATRIC REHAB OF NO. VA, P.C. |
| Practice Address |
2826 Old Lee Hwy Suite 200 Fairfax VA 22031-4323 |
| Mailing Address |
2730 Prosperity Ave Ste B Fairfax VA 22031-4330 |
| Practice Telephone | 8777033448 |
| Practice Fax Number | 3016687008 |
| Mailing Telephone | 7032891435 |
| Mailing Fax Number | 7032891414 |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2012-10-08 |
| Authorized Official Name | RHONDA VIOLA (BUSINESS MANAGER) |
| Authorized Official Telephone | 2403977003 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P0010X |
Physical Medicine & Rehabilitation Specialization: Pediatric Rehabilitation Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
2826 OLD LEE HWY SUITE 200 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22031-4323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609879303 | Fareeha I Khan | Specialist | 2826 Old Lee Hwy, Suite 100, Fairfax, VA 22031 | 2005-05-27 |
| 1013308808 | Elizabeth Ann Myers | Physician Assistant | 2826 Old Lee Hwy, Suite #330, Fairfax, VA 22031-4323 | 2015-02-15 |
| 1942691019 | Nova Reconstructive Surgery LLC | Plastic Surgery | 2826 Old Lee Hwy, Ste 330, Fairfax, VA 22031-4323 | 2015-02-11 |
| 1205242419 | Megan Condrey | Physician Assistant | 2826 Old Lee Hwy, Ste. 330, Fairfax, VA 22031-4323 | 2014-07-08 |
| 1306189816 | Nassar F Khan Md PC | Specialist | 2826 Old Lee Hwy, Suite # 110, Fairfax, VA 22031-4323 | 2013-04-03 |
| 1649573205 | Jay Daniel Ryan | Podiatrist | 2826 Old Lee Hwy, Suite 220, Fairfax, VA 22031-4323 | 2010-12-20 |
| 1285940502 | Mahadevappa Hunasikatti Md PC | Internal Medicine | 2826 Old Lee Hwy, Suite 330, Fairfax, VA 22031-4323 | 2010-08-24 |
| 1750695896 | Plastic Surgery Consultants, LLC | Plastic Surgery | 2826 Old Lee Hwy, Suite 330, Fairfax, VA 22031-4323 | 2010-07-30 |
| 1073757662 | Active Medical Care, Inc. | Specialist | 2826 Old Lee Hwy, Ste 330, Fairfax, VA 22031-4323 | 2009-04-27 |
| 1003074113 | Greater Washington Plastic Surgery Associates, LLC | Plastic Surgery | 2826 Old Lee Hwy, Suite 330, Fairfax, VA 22031 | 2008-05-26 |
| Find all providers in the same location | ||||
| 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 | 2081P0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pediatric Rehabilitation Medicine |
| A physiatrist who utilizes an interdisciplinary approach and addresses the prevention, diagnosis, treatment and management of congenital and childhood-onset physical impairments including related or secondary medical, physical, functional, psychosocial and vocational limitations or conditions, with an understanding of the life course of disability. This physician is trained in the identification of functional capabilities and selection of the best of rehabilitation intervention strategies, with an understanding of the continuum of care. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate for PRM was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Early discussions underway |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790297828 | Patricia Ann Vannucchi | Physical Medicine & Rehabilitation | 1589 Wingfield Dr, Hampton, VA 23666-4822 | 2017-10-30 |
| 1821027434 | Karen A Steidle | Physical Medicine & Rehabilitation | 1250 E. Marshall St, Richmond, VA 23291-0001 | 2006-07-03 |
| 1467414995 | Katrina Marie Lesher | Physical Medicine & Rehabilitation | 850 Southampton Ave, Norfolk, VA 23510-1021 | 2006-04-03 |
| 1639705213 | Kate Yates | Physical Medicine & Rehabilitation | 101 Elm Ave Se, Roanoke, VA 24013-2222 | 2020-03-16 |
| 1528694262 | Emily Guill | Physical Medicine & Rehabilitation | 101 Elm Ave Se, Roanoke, VA 24013-2222 | 2020-03-13 |
| 1649806399 | Megan Silber | Physical Medicine & Rehabilitation | 101 Elm Ave Se, Roanoke, VA 24013-2222 | 2020-03-13 |
| 1053947705 | Lauren Maxwell | Physical Medicine & Rehabilitation | 672 Naff Rd, Boones Mill, VA 24065-1992 | 2020-03-13 |
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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.