Organization Active NPI

Fairfax Cardiology PC

  • Cardiovascular Disease Physician
  • Fairfax, VA
National Provider Identifier
1114974896
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
FAIRFAX CARDIOLOGY PC
Practice address
10721 Main St
Suite 3200
Fairfax, VA 22030-6914
Phone
(703) 591-7770
Fax
(703) 591-8162
NPI assigned
May 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Linda G Shanahan
Title
Office Manager
Phone
(703) 591-7770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

10721 Main St
Suite 3200
Fairfax, VA 22030-6914

Mailing address

10721 Main St
Suite 3200
Fairfax, VA 22030-6914
Phone (703) 591-7770

National Provider Directory

National Provider Directory

Locations

10721 Main St
#S3200
Fairfax, VA 22030
Phone (703) 591-7770

Practitioners & affiliated clinicians

Practitioners 2

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": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114974896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST",
            "address_2": "SUITE 3200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306914",
            "telephone_number": "703-591-7770",
            "fax_number": "703-591-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST",
            "address_2": "SUITE 3200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306914",
            "telephone_number": "703-591-7770",
            "fax_number": "703-591-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFAX CARDIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHANAHAN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "703-591-7770",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.