Individual provider Active NPI

Ali Jadidi, MD

  • Emergency Medicine Physician
  • Woodbridge, VA
National Provider Identifier
1013010180
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101230761 Issued in VA
Practice address
14904 Jefferson Davis Hwy
Suite 207
Woodbridge, VA 22191-3311
Phone
(703) 492-1400
Fax
(703) 492-0220
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101230761 VA Primary

Addresses

Primary practice location

14904 Jefferson Davis Hwy
Suite 207
Woodbridge, VA 22191-3311

Mailing address

14904 Jefferson Davis Highway
Ste 207
Woodbridge, VA 22191-3908
Phone (703) 492-1400

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
0101230761VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bestpractices, Inc. Emergency Medicine Past Accepting new patients
Prince William Pediatrics and Adolescent Center Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013010180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14904 JEFFERSON DAVIS HIGHWAY",
            "address_2": "STE 207",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913908",
            "telephone_number": "703-492-1400",
            "fax_number": "703-492-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14904 JEFFERSON DAVIS HWY",
            "address_2": "SUITE 207",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913311",
            "telephone_number": "703-492-1400",
            "fax_number": "703-492-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JADIDI",
        "first_name": "ALI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101230761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.