Dulles Health LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101235079 Issued in VA

Legal business name

DULLES HEALTH LLC

Practice address

4080 Lafayette Center Dr
Suite # 110
Chantilly, VA 20151-1247

Phone

(703) 961-1680

NPI assigned

Apr 20, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vijaya L Gorle, M.D.NPI 1750371803

Title

Principal

Phone

(703) 961-1680

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vijaya Lakshmi Gorle, M.D.

  • Internal Medicine Physician
  • Chantilly, VA
  • NPI 1750371803

  DC

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093933723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 LAFAYETTE CENTER DR",
            "address_2": "SUITE # 110",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511247",
            "telephone_number": "703-961-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 LAFAYETTE CENTER DR",
            "address_2": "SUITE # 110",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511247",
            "telephone_number": "703-961-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DULLES HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORLE",
        "authorized_official_first_name": "VIJAYA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "703-961-1680",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101235079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Caitlin Elizabeth Duble, LCSW
• Corinne Marie Ducey, RN
• Dulles Oral Surgical Center
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• Internal Medicine Physician in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.