Organization Active NPI

Gastro Virginia LLC

  • Gastroenterology Physician
  • Fairfax, VA
National Provider Identifier
1003632373
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GASTRO VIRGINIA LLC
Practice address
12011 Route 50 Ste 506
Fairfax, VA 22033-3315
Phone
(484) 339-6869
Fax
(484) 214-9609
NPI assigned
Dec 2, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Authorized official

Name
Zachary Jones
Title
Ceo
Phone
(207) 631-7837

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

12011 Route 50 Ste 506
Fairfax, VA 22033-3315

Mailing address

7120 Minstrel Way Ste 100
Columbia, MD 21045-5274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260507001371 DC Part B Supplier - Clinic/Group Practice 1759859788 Receives reassigned benefits from 5 practitioners
Practice locations: Fairfax, VA

National Provider Directory

National Provider Directory

Locations

12011 Route 50
Ste 506
Fairfax, VA 22033
Phone (484) 339-6869

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777334400000",
    "number": "1003632373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 MINSTREL WAY STE 100",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12011 ROUTE 50 STE 506",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333315",
            "telephone_number": "484-339-6869",
            "fax_number": "484-214-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTRO VIRGINIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-02",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-631-7837"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.