NPIMap

Organization Active NPI

Discovery Practice Management, Inc.

Doing business as Discovery Mood & Anxiety Program, Fairfax OP

  • Psychiatric Residential Treatment Facility
  • Fairfax, VA
National Provider Identifier
1063072684
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
DISCOVERY PRACTICE MANAGEMENT, INC.
Doing business as
Discovery Mood & Anxiety Program, Fairfax OP
Practice address
10340 Democracy LN Ste 204
Fairfax, VA 22030-2518
Phone
(714) 828-1800
Fax
(714) 882-1186
NPI assigned
Jun 17, 2019
Organization subpart
Yes
Parent organization
DISCOVERY PRACTICE MANAGEMENT, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Authorized official

Name
Magdalen Gustilo
Title
Director of Payer Relations
Phone
(714) 568-7667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X Primary

Addresses

Primary practice location

10340 Democracy LN Ste 204
Fairfax, VA 22030-2518

Mailing address

18401 Von Karman Ave Ste 500
Irvine, CA 92612-8531
Phone (714) 828-1800

Other names 1

  • Discovery Mood & Anxiety Program, Fairfax OP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Discovery Practice Management Inc105 organizations share this tax ID, including this one
Part of
Discovery Practice Management Inc

Organizations with this tax ID in the same state 6

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

10340 Democracy Ln
Ste 204
Fairfax, VA 22030

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1063072684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18401 VON KARMAN AVE STE 500",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926128531",
            "telephone_number": "714-828-1800",
            "fax_number": "714-882-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10340 DEMOCRACY LN STE 204",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302518",
            "telephone_number": "714-828-1800",
            "fax_number": "714-882-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISCOVERY PRACTICE MANAGEMENT, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DISCOVERY PRACTICE MANAGEMENT, INC.",
        "enumeration_date": "2019-06-17",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "GUSTILO",
        "authorized_official_first_name": "MAGDALEN",
        "authorized_official_title_or_position": "DIRECTOR OF PAYER RELATIONS",
        "authorized_official_telephone_number": "714-568-7667"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Discovery Mood & Anxiety Program, Fairfax OP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Discovery Mood & Anxiety Program, Fairfax OP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 9, 2023; 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.