Individual provider Active NPI

Cheryl A Lindstrom, MD

  • Diagnostic Radiology Physician
  • Fairfax, VA
National Provider Identifier
1003834029
Registry record updated Nov 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101048442 Issued in VA
Practice address
2722 Merrilee Dr
Suite 230
Fairfax, VA 22031-4400
Phone
(703) 698-4444
Fax
(703) 698-2176
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2010

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 0101048442 VA
Neuroradiology Physician 2085N0700X 0101048422 VA
Nuclear Radiology Physician 2085N0904X 0101048422 VA
Pediatric Radiology Physician 2085P0229X 0101048442 VA
Diagnostic Radiology Physician 2085R0202X 0101048442 VA Primary
Vascular & Interventional Radiology Physician 2085R0204X 0101048442 VA
Diagnostic Ultrasound Physician 2085U0001X 0101048442 VA

Addresses

Primary practice location

2722 Merrilee Dr
Suite 230
Fairfax, VA 22031-4400

Mailing address

2722 Merrilee Dr
Ste 230
Fairfax, VA 22031-4420
Phone (703) 698-4444

Other identifiers 6

IdentifierTypeStateIssuer
101433OtherVAKAISER PERMANENTE
7200974000MedicaidWV
2036287OtherVAAETNA HMO
4270212OtherVAAETNA PPO
0029OtherVACAREFIRST
58981OtherVAAMERIGROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101048422VAMDNeuroradiology Physician
0101048442VAMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290729600000",
    "number": "1003834029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2722 MERRILEE DR",
            "address_2": "STE 230",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314420",
            "telephone_number": "703-698-4444",
            "fax_number": "703-698-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2722 MERRILEE DR",
            "address_2": "SUITE 230",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314400",
            "telephone_number": "703-698-4444",
            "fax_number": "703-698-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSTROM",
        "first_name": "CHERYL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "VA",
            "license": "0101048442",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "VA",
            "license": "0101048422",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "VA",
            "license": "0101048422",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "VA",
            "license": "0101048442",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101048442",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "VA",
            "license": "0101048442",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "VA",
            "license": "0101048442",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER PERMANENTE",
            "identifier": "101433",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7200974000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2036287",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4270212",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "0029",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "58981",
            "state": "VA"
        }
    ],
    "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 Nov 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.