Northern Virginia Radiology and Nuclear Medicine,Inc

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

NORTHERN VIRGINIA RADIOLOGY AND NUCLEAR MEDICINE,INC

Practice address

8320 Old Courthouse Rd
#150
Vienna, VA 22182-3831

Phone

(703) 356-9674

Fax

(703) 356-9589

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Panos G Koutrouvelis, M.D.

Title

President

Phone

(703) 356-9674

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124241807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8320 OLD COURTHOUSE RD",
            "address_2": "#150",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823831",
            "telephone_number": "703-356-9674",
            "fax_number": "703-356-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 OLD COURTHOUSE RD",
            "address_2": "#150",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823831",
            "telephone_number": "703-356-9674",
            "fax_number": "703-356-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN VIRGINIA RADIOLOGY AND NUCLEAR MEDICINE,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOUTROUVELIS",
        "authorized_official_first_name": "PANOS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-356-9674",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "039101",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7204876",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "7857",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Vienna, VA
• Providers in Vienna, VA by specialty
• Specialist 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.