NPIMap

Organization Active NPI

Old Dominion Medical Center, P.C.

  • Family Medicine Physician
  • McLean, VA
National Provider Identifier
1104990167
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OLD DOMINION MEDICAL CENTER, P.C.
Practice address
6715 Whittier Avenue
Suite 100
McLean, VA 22101
Phone
(703) 356-5700
Fax
(703) 448-8211
NPI assigned
Nov 20, 2006
Last updated
Feb 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Authorized official

Name
Dr. Allen Bernard Horne, M.D.NPI 1225178296
Title
Physician Owner
Phone
(703) 356-5700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6715 Whittier Avenue
Suite 100
McLean, VA 22101

Mailing address

6715 Whittier Avenue
Suite 100
McLean, VA 22101
Phone (703) 356-5700

National Provider Directory

National Provider Directory

Locations

6715 Whittier Ave
Ste 100
McLean, VA 22101
Phone (703) 356-5700

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454544000000",
    "number": "1104990167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6715 WHITTIER AVENUE",
            "address_2": "SUITE 100",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "22101",
            "telephone_number": "703-356-5700",
            "fax_number": "703-448-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6715 WHITTIER AVENUE",
            "address_2": "SUITE 100",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "22101",
            "telephone_number": "703-356-5700",
            "fax_number": "703-448-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD DOMINION MEDICAL CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2016-02-04",
        "status": "A",
        "authorized_official_last_name": "HORNE",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "703-356-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.