Organization Active NPI

Gastroenterology Center of Northern Virginia LTD

  • Gastroenterology Physician
  • Annandale, VA
National Provider Identifier
1154546158
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GASTROENTEROLOGY CENTER OF NORTHERN VIRGINIA LTD
Practice address
3299 Woodburn Road
Suite 220
Annandale, VA 22003
Phone
(703) 560-6106
Fax
(703) 204-1968
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

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

Authorized official

Name
Gabriel B Herman, MDNPI 1437231289
Title
President
Phone
(703) 560-6106

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

3299 Woodburn Road
Suite 220
Annandale, VA 22003

Mailing address

3299 Woodburn Road
Suite 220
Annandale, VA 22003
Phone (703) 560-6106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050707000466 DC Part B Supplier - Clinic/Group Practice 0042256406 Receives reassigned benefits from 6 practitioners
Practice locations: Annandale, VA; Arlington, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2165030Gastroenterology Center of Northern Virginia, LTD3299 Woodburn Road, Suite 220, Annandale, VA 22003ComplianceDec 10, 2027

National Provider Directory

National Provider Directory

Locations

3301 Woodburn Rd
Ste 220
Annandale, VA 22003

3299 Woodburn Rd
#202
Annandale, VA 22003

3299 Woodburn Rd
Ste 220
Annandale, VA 22003
Phone (220) 270-3747

1625 N George Mason Dr
Fl 2
Arlington, VA 22205
Phone (703) 558-6585

8301 Arlington Blvd
Ste 405
Fairfax, VA 22031
Phone (703) 560-6106

Practitioners & affiliated clinicians

Practitioners 6

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": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365984000000",
    "number": "1154546158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3299 WOODBURN ROAD",
            "address_2": "SUITE 220",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "22003",
            "telephone_number": "703-560-6106",
            "fax_number": "703-204-1968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3299 WOODBURN ROAD",
            "address_2": "SUITE 220",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "22003",
            "telephone_number": "703-560-6106",
            "fax_number": "703-204-1968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY CENTER OF NORTHERN VIRGINIA LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2013-04-15",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-560-6106",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.