NPIMap

Organization Active NPI

Bradlee Family Health Center

  • Primary Care Clinic/Center
  • Alexandria, VA
National Provider Identifier
1013335371
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
101223709 Issued in VA
Legal business name
BRADLEE FAMILY HEALTH CENTER
Practice address
3541 W Braddock Rd
101
Alexandria, VA 22302-1915
Phone
(703) 379-6020
Fax
(703) 820-8799
NPI assigned
Apr 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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

Authorized official

Name
Dr. Leslie George Gondor, MDNPI 1265548804
Title
Owner/President
Phone
(703) 379-6020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 101223709 VA Primary

Addresses

Primary practice location

3541 W Braddock Rd
101
Alexandria, VA 22302-1915

Mailing address

3541 W Braddock Rd
Suite 101
Alexandria, VA 22302-1915
Phone (703) 379-6020

Other identifiers 8

IdentifierTypeStateIssuer
2466957OtherUNITED HEALTH CARE
4718781OtherCIGNA
3681092OtherAETNA HMO
7782527OtherAETNA PPO
283569OtherVAINTOTAL
172715OtherANTHEM HEALTHKEEPERS
5613060MedicaidVA
K2040001OtherDCBCBS

National Provider Directory

National Provider Directory

Locations

3541 W Braddock Rd
Ste 101
Alexandria, VA 22302
Phone (703) 379-6020

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8529/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

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": "1396483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396483200000",
    "number": "1013335371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3541 W BRADDOCK RD",
            "address_2": "SUITE 101",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021915",
            "telephone_number": "703-379-6020",
            "fax_number": "703-820-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3541 W BRADDOCK RD",
            "address_2": "101",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021915",
            "telephone_number": "703-379-6020",
            "fax_number": "703-820-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEE FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-03",
        "last_updated": "2014-04-03",
        "status": "A",
        "authorized_official_last_name": "GONDOR",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "703-379-6020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VA",
            "license": "101223709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2466957",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4718781",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3681092",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7782527",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTOTAL",
            "identifier": "283569",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM HEALTHKEEPERS",
            "identifier": "172715",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5613060",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "K2040001",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; 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.