NPIMap

Organization Active NPI

Inova Health Care Services

Doing business as Inova Mount Vernon Hospital

  • Psychiatric Hospital Unit
  • Alexandria, VA
National Provider Identifier
1104957083
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
INOVA HEALTH CARE SERVICES
Doing business as
Inova Mount Vernon Hospital
Practice address
2501 Parkers LN
Alexandria, VA 22306-3209
Phone
(703) 664-7000
NPI assigned
Mar 9, 2007
Last updated
Jul 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Authorized official

Name
Ricardo Talento
Title
Corporate Chief Financial Officer
Phone
(571) 472-8717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

2501 Parkers LN
Alexandria, VA 22306-3209

Mailing address

8095 Innovation Park Dr
Fairfax, VA 22031-4868
Phone (540) 272-7378

Other identifiers 1

IdentifierTypeStateIssuer
004901223MedicaidVA

Other names 1

  • Inova Mount Vernon Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100318000671 VA Part A Provider - Hospital 2466351093 Practice locations: Alexandria, VA
O20121219000193 DC Part B Supplier - Clinic/Group Practice 2466351093 Receives reassigned benefits from 168 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Springfield, VA; Vienna, VA; Reston, VA; Falls Church, VA; Fairfax, VA; Centreville, VA; Arlington, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104957083. Details of each certification follow.

Hospital certification: CCN 49S122

Legal name
INOVA HEALTH CARE SERVICES
Doing business as
INOVA MT VERNON HOSPITAL
Organization structure
CorporationProprietary
Incorporated
Feb 13, 1956 in VA
Enrollment address
2501 Parkers LN
Alexandria, VA 22306-3209
Hospital Psychiatric Unit
Hospital subgroups
Acute care, Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 23

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 23

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Fairfax Hosp Lab37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Locations

2990 Telestar Ct
Falls Church, VA 22042
Phone (703) 208-5929

Ownership & related parties

All disclosed owners & managing parties 24

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Madeline Erario Individual Corporate DirectorBoard Member Jan 1, 2022
Roberta a Tinch Individual W-2 Managing EmployeePresident Inova Mount Vernon Hospit Sep 16, 2019
Bruce Caswell Individual Corporate DirectorBoard Member Jan 1, 2025
Timothy Gillis Individual Corporate DirectorBoard Member Jan 1, 2025
Inova Health Systems Foundation Organization, Fairfax, VA Corporation, Non-profit 5% Or Greater Direct Ownership Interest May 1, 1978 100%
Operational/Managerial Control May 1, 1978 100%
Ricardo Talento Individual W-2 Managing EmployeeCorporate Chief Financial Officer Jun 5, 2017
Terri McClements Individual Corporate DirectorTreasurer Jan 1, 2025
Jeffrey McKay Individual Corporate DirectorBoard Member Jan 1, 2025
Jace Stephen Jones Individual Corporate OfficerPresident Apr 9, 2018
Corporate DirectorBoard Member Apr 9, 2018
Renee Desilva Individual Corporate DirectorBoard Member Jan 1, 2022
Eliot J Fredd Individual W-2 Managing EmployeeSr Dir Revenue Cycle Sbo Patient MG Nov 18, 2024
Toni Ardabell Individual W-2 Managing EmployeeAssoc Chief, Clinical Operations Jul 22, 2019
Kathryn Falk Individual Corporate DirectorBoard Member Jan 1, 2022
Maureen Sintich Individual W-2 Managing EmployeeChief Nurse Executive Jul 1, 2019
Jill Duncan Individual Corporate DirectorBoard Member Jan 1, 2022
Christopher Smith Individual W-2 Managing EmployeeVP Finance & Corporate Controller Jul 14, 2019
John Gaul Individual Corporate DirectorAsst. Secretary Jan 1, 2012
Lesley Kalan Individual Corporate DirectorBoard Member Jan 1, 2022
Paul Misener Individual Corporate DirectorBoard Member Jan 1, 2025
Tracy R Bish Individual W-2 Managing EmployeeAvp Revenue Cycle Operations Jan 1, 2006
Nazzic Keene Individual Corporate DirectorBoard Member Jan 1, 2022
Craig Albert Individual Corporate OfficerBoard Member Jan 1, 2025
Olin Marcus McClain Individual W-2 Managing EmployeeSr Director of System Office Claims Nov 1, 2018
Jean Stack Individual Corporate DirectorBoard Member Jan 1, 2023

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Inova Home Health LLCFairfax, VA, CCN 497008 Home health agency 5% Or Greater Indirect Ownership Interest (51%) Sep 5, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 9

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 2

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": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751932800000",
    "number": "1104957083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8095 INNOVATION PARK DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314868",
            "telephone_number": "540-272-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 PARKERS LN",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223063209",
            "telephone_number": "703-664-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INOVA HEALTH CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A",
        "authorized_official_last_name": "TALENTO",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_title_or_position": "CORPORATE CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "571-472-8717"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004901223",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Inova Mount Vernon Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Inova Mount Vernon Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.