Fair Ridge OB/GYN Associates , PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

FAIR RIDGE OB/GYN ASSOCIATES , PC

Practice address

4001 Fair Ridge Dr
202
Fairfax, VA 22033-2917

Phone

(703) 591-2223

Fax

(703) 591-2270

NPI assigned

Oct 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Walter James Hodges Jr., MD

Title

President

Phone

(703) 264-7801

Specialties & licenses 1

Addresses

Other names 1

• Walter J. Hodges Jr. MD PC Former legal business name

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1043392434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 JOSEPH SIEWICK DR",
            "address_2": "400",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331756",
            "telephone_number": "703-264-7801",
            "fax_number": "703-264-7807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 FAIR RIDGE DR",
            "address_2": "202",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332917",
            "telephone_number": "703-591-2223",
            "fax_number": "703-591-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIR RIDGE OB/GYN ASSOCIATES , PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-264-7801",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walter J. Hodges Jr. MD PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.