NPIMap

Organization Active NPI

Amen Clinics, Inc DC

  • Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
  • Reston, VA
National Provider Identifier
1124534607
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Neuroimaging (Psychiatry & Neurology) PhysicianTaxonomy code 2084D0003X
Legal business name
AMEN CLINICS, INC DC
Practice address
10701 Parkridge Blvd Ste 110
Reston, VA 20191-4423
Phone
(703) 880-4000
Fax
(703) 860-5760
NPI assigned
Dec 20, 2017
Organization subpart
Yes
Parent organization
AMEN CLINICS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Authorized official

Name
Christina T McCormick
Title
Corporate Trainer
Phone
(703) 880-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Neuroimaging (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084D0003X Primary

Addresses

Primary practice location

10701 Parkridge Blvd Ste 110
Reston, VA 20191-4423

Mailing address

10701 Parkridge Blvd Ste 110
Reston, VA 20191-4423
Phone (703) 880-4000

National Provider Directory

National Provider Directory
Tax ID family
Amen Clinics Inc Walnut Creek11 organizations share this tax ID, including this one
Part of
Amen Clinics Inc Walnut Creek

Other organizations with this tax ID 10

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

Locations

10701 Parkridge Blvd
Ste 110
Reston, VA 20191
Phone (703) 880-4000

Practitioners & affiliated clinicians

Practitioners 8

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": "1513728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1124534607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 PARKRIDGE BLVD STE 110",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201914423",
            "telephone_number": "703-880-4000",
            "fax_number": "703-860-5760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 PARKRIDGE BLVD STE 110",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201914423",
            "telephone_number": "703-880-4000",
            "fax_number": "703-860-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMEN CLINICS, INC DC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMEN CLINICS, INC",
        "enumeration_date": "2017-12-20",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CORPORATE TRAINER",
        "authorized_official_telephone_number": "703-880-4000"
    },
    "taxonomies": [
        {
            "code": "2084D0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Diagnostic Neuroimaging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.