Organization Active NPI

Skyline Psychiatric Associates Inc

  • Psychiatry Physician
  • Alexandria, VA
National Provider Identifier
1093758278
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SKYLINE PSYCHIATRIC ASSOCIATES INC
Practice address
1500 N Beauregard St
Suite 240
Alexandria, VA 22311-1715
Phone
(703) 575-8101
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Authorized official

Name
Leeann Gargasz
Title
Office Manager
Phone
(703) 575-8101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1500 N Beauregard St
Suite 240
Alexandria, VA 22311-1715

Mailing address

1500 N Beauregard St
Suite 240
Alexandria, VA 22311-1715
Phone (703) 575-8101

Other identifiers 1

IdentifierTypeStateIssuer
1093758278MedicaidVA

National Provider Directory

National Provider Directory

Locations

1500 N Beauregard St
Ste 420
Alexandria, VA 22311
Phone (703) 504-6844

Practitioners & affiliated clinicians

Practitioners 3

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": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278028800000",
    "number": "1093758278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N BEAUREGARD ST",
            "address_2": "SUITE 240",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111715",
            "telephone_number": "703-575-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N BEAUREGARD ST",
            "address_2": "SUITE 240",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111715",
            "telephone_number": "703-575-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLINE PSYCHIATRIC ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2010-07-02",
        "status": "A",
        "authorized_official_last_name": "GARGASZ",
        "authorized_official_first_name": "LEEANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "703-575-8101"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093758278",
            "state": "VA"
        }
    ],
    "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 Jul 2, 2010; 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.