NPIMap

Organization Active NPI

ENT & Allergy Specialists of Virginia PC

  • Otolaryngology/Facial Plastic Surgery Physician
  • Ashburn, VA
National Provider Identifier
1093992570
Registry record updated Jan 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
0101237837 Issued in VA
Legal business name
ENT & ALLERGY SPECIALISTS OF VIRGINIA PC
Practice address
44320 Premier PLZ
Suite 110
Ashburn, VA 20147-5076
Phone
(703) 723-8727
Fax
(703) 723-9787
NPI assigned
Jan 27, 2008
Last updated
Jan 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2009

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

Authorized official

Name
Dr. James Jay Lee, M.D.NPI 1326052184
Title
President
Phone
(703) 723-8727

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 0101242747 VA
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 0101237837 VA Primary

Addresses

Primary practice location

44320 Premier PLZ
Suite 110
Ashburn, VA 20147-5076

Mailing address

44320 Premier PLZ
Suite 110
Ashburn, VA 20147-5076
Phone (703) 723-8727

Other identifiers 1

IdentifierTypeStateIssuer
0101237837MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080710000047 VA Part B Supplier - Clinic/Group Practice 8921170820 Receives reassigned benefits from 3 practitioners
Practice locations: Ashburn, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1201392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232668800000",
    "number": "1093992570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44320 PREMIER PLZ",
            "address_2": "SUITE 110",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475076",
            "telephone_number": "703-723-8727",
            "fax_number": "703-723-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44320 PREMIER PLZ",
            "address_2": "SUITE 110",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475076",
            "telephone_number": "703-723-8727",
            "fax_number": "703-723-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT & ALLERGY SPECIALISTS OF VIRGINIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-27",
        "last_updated": "2009-01-23",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-723-8727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "VA",
            "license": "0101242747",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "VA",
            "license": "0101237837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0101237837",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; 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.