NPIMap

Organization Active NPI

Neighborhood Health

Doing business as Neighborhood Health at Merrifield Center

  • Federally Qualified Health Center (FQHC)
  • Fairfax, VA
National Provider Identifier
1003354416
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEIGHBORHOOD HEALTH
Doing business as
Neighborhood Health at Merrifield Center
Practice address
8221 Willow Oaks Corporate Dr
Fairfax, VA 22031-4512
Phone
(703) 535-5568
Fax
(703) 299-1794
NPI assigned
Feb 6, 2017
Last updated
Feb 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Basim Khan, MDNPI 1477880045
Title
Ceo
Phone
(703) 535-5568

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031-4512

Mailing address

PO Box 4320
Glen Allen, VA 23058-4320
Phone (804) 237-7690

Other names 1

  • Neighborhood Health at Merrifield Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040707000325 DC Part B Supplier - Clinic/Group Practice 7517853419 Receives reassigned benefits from 100 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fairfax, VA; Annandale, VA; Alexandria, VA
O20170426001828 VA Part A Provider - Federally Qualified Health Center (FQHC) 7517853419 Practice locations: Fairfax, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003354416. Details of each certification follow.

Federally qualified health center certification: CCN 491951

Legal name
NEIGHBORHOOD HEALTH
Doing business as
NEIGHBORHOOD HEALTH AT MERRIFIELD CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 6, 2017
Last certification
Mar 6, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 27, 1997 in VA
Enrollment address
8221 Willow Oaks Corporate Dr
Lowr Level
Fairfax, VA 22031-4512

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Neighborhood Health23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

6677 Richmond Hwy
Alexandria, VA 22306

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14593/brand/1/csg/1/fhir/r4

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Alisa Whyte Individual Corporate DirectorBoard Member Aug 21, 2017
Miriam Aguila Individual Corporate DirectorBoard Member Oct 18, 2015
Nora Partlow Individual Corporate DirectorBoard Member Oct 5, 2015
Basim N Khan Individual Corporate DirectorCeo Feb 9, 2015
W-2 Managing EmployeeCeo Feb 9, 2015
Operational/Managerial Control Feb 9, 2015 100%
Lisa Chimento Individual Corporate DirectorBoard Treasurer/Secretary Sep 20, 2020
Michael Millman Individual Corporate DirectorBoard President Mar 30, 2015
Muhammad Arif Individual Corporate DirectorBoard Member Dec 17, 2018
Lolita Youmans Individual Corporate DirectorBoard Member Dec 20, 2021
Elhafedh Talebimijine Individual Corporate DirectorBoard Member Mar 18, 2019
Paola Navarro Individual Corporate DirectorBoard Member Oct 5, 2015

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486339200000",
    "number": "1003354416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4320",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230584320",
            "telephone_number": "804-237-7690",
            "fax_number": "804-237-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8221 WILLOW OAKS CORPORATE DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314512",
            "telephone_number": "703-535-5568",
            "fax_number": "703-299-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORHOOD HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-06",
        "last_updated": "2017-02-06",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "BASIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "703-535-5568",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neighborhood Health at Merrifield Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.