NPIMap

Organization Active NPI

Fairfax Family Practice Centers PC

  • Family Medicine Physician
  • Vienna, VA
National Provider Identifier
1013032283
Registry record updated Dec 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAIRFAX FAMILY PRACTICE CENTERS PC
Practice address
115 Park Street
Suite 300
Vienna, VA 22180
Phone
(703) 255-9100
Fax
(703) 255-3457
NPI assigned
Mar 20, 2007
Organization subpart
Yes
Parent organization
FAIRFAX FAMILY PRACTICE CENTERS PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 26, 2007

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

Authorized official

Name
James P Jenkins, MD
Title
President
Phone
(703) 255-9100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

115 Park Street
Suite 300
Vienna, VA 22180

Mailing address

PO Box 791128
Baltimore, MD 21279-1128
Phone (703) 255-9100

Other names 1

  • Vienna Family Medicine Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D0665151Vienna Family Medicine115 Park St, SE Suite 300, Vienna, VA 22180Certificate of waiverDec 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Fairfax Family Prac Cen10 organizations share this tax ID, including this one
Part of
Fairfax Family Prac Cen

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198627200000",
    "number": "1013032283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791128",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212791128",
            "telephone_number": "703-255-9100",
            "fax_number": "703-255-3457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PARK STREET",
            "address_2": "SUITE 300",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "22180",
            "telephone_number": "703-255-9100",
            "fax_number": "703-255-3457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFAX FAMILY PRACTICE CENTERS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAIRFAX FAMILY PRACTICE CENTERS PC",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-12-26",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-255-9100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vienna Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.